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Symptomatic colonic spirochaetosis in an immunocompetent patient
  1. R K Lin,
  2. K Miyai,
  3. J M Carethers
  1. Department of Medicine, Division of Gastroenterology, University of California, San Diego, California, USA
  1. Correspondence to:
 J M Carethers
 Division of Gastroenterology, UCSD, 9500 Gilman Drive 0063, La Jolla, CA92093-0063, USA; jcarethers{at}


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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  • Competing interests: None declared.