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Journal of Clinical Pathology 2006;59:1100-1101; doi:10.1136/jcp.2005.034900
Copyright © 2006 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

CASE REPORT

Symptomatic colonic spirochaetosis in an immunocompetent patient

R K Lin, K Miyai, J M Carethers

Department of Medicine, Division of Gastroenterology, University of California, San Diego, California, USA

Correspondence to:
Correspondence to:
J M Carethers
Division of Gastroenterology, UCSD, 9500 Gilman Drive 0063, La Jolla, CA92093-0063, USA; jcarethers{at}ucsd.edu

ABSTRACT

Spirochaetes are organisms that can infect the colon of people with normal or compromised immune systems. Infected patients can present with a variety of gastrointestinal symptoms, including diarrhoea and rectal bleeding. However, some report a lack of association between specific symptoms and the presence of spirochaetes. It is therefore unclear whether the spirochaetes colonising the colon are true pathogens. Diagnosis is typically made by histological examination, with the biopsy specimen showing a band-like growth of spirochaetes adherent to the colonic luminal surface, giving an accentuated brush-border appearance. A course of metronidazole can eliminate the spirochaetes, but treatment might not lead to improvement of symptoms. Owing to the lack of a definite association between symptoms and the presence of spirochaetes, observation without specific antibiotic treatment can be pursued in most patients.


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This article has been cited by other articles:

  • O'Donnell, S, Swan, N, Crotty, P, Sangster, D, O'Morain, C (2008). Assessment of the clinical significance of intestinal spirochaetosis. J. Clin. Pathol. 61: 1029-1033 [Abstract] [Full Text]  

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