Intestinal Spirochetosis mimicking inflammatory bowel disease in children

Helbling, Rossana; Osterheld, Maria‐Chiara; Vaudaux, Bernard; Jaton, Katia; Nydegger, Andreas

doi:10.1186/1471-2431-12-163

Cited by 19 publications

(44 citation statements)

References 26 publications

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“…IS should be considered to be an opportunistic infection in immunodeficient patients. Both adult and pediatric cases have been reported [7]. Transmission generally occurs by the fecal-oral route (exposure to contaminated water and/or contact with infected animals, potential for zoonotic spread), but sexual transmission does occur in homosexual men [7].…”

Section: Discussionmentioning

confidence: 99%

Intestinal Bacterial Infection Diagnosed by Histological Examination of Endoscopic Biopsy Specimens

Yuki

Emoto

Yoshizawa

et al. 2016

Case Rep Gastroenterol

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Intestinal spirochetosis (IS) in humans is characterized by spirochetal microorganisms attached to the luminal surface of the colonic epithelium. In the present case, attached organisms appeared as 3- to 4 μm-thick (average thickness, 3.4 μm) basophilic fringes or haze in HE-stained endoscopic biopsy specimens. The basophilic fringes were clearly labeled by Treponema pallidum antiserum. Because IS is relatively rare in developed countries, thin basophilic fringes characteristic of IS are readily overlooked. Thus, the recognition of histological characteristics of this disease is important for its diagnosis.

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Section: Discussionmentioning

confidence: 99%

Intestinal Bacterial Infection Diagnosed by Histological Examination of Endoscopic Biopsy Specimens

Yuki

Emoto

Yoshizawa

et al. 2016

Case Rep Gastroenterol

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“…Individuals with biopsy samples showing evidence of HIS may have one or another of a range of nonspecific symptoms attributable to an underlying chronic intestinal complaint for which other potential etiological factors have been excluded. Examples include abdominal pain, change in bowel habits, pseudoappendicitis, irritable bowel, diverticulitis, chronic nonwatery diarrhea, and rectal bleeding (86)(87)(88)(89)(90)(91). On the other hand, HIS also has been observed as an incidental finding in biopsy specimens taken for other reasons; in such cases, and particularly where specific pathological changes are not found, the spirochetes appear to have a commensal relationship with the host (92).…”

Section: Disease In Humansmentioning

confidence: 96%

“…Consequently, failure to detect attached spirochetes in no way excludes the possibility that B. pilosicoli is colonizing the large intestine. To improve prospects for diagnosis, it is recommended that multiple biopsy specimens or samples be taken from throughout the colon to look for localized areas of attachment (91).…”

Section: Biopsy Specimens and Colonic Mucosamentioning

confidence: 99%

The Spirochete Brachyspira pilosicoli, Enteric Pathogen of Animals and Humans

Hampson

2018

Clin Microbiol Rev

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SUMMARY Brachyspira pilosicoli is a slow-growing anaerobic spirochete that colonizes the large intestine. Colonization occurs commonly in pigs and adult chickens, causing colitis/typhlitis, diarrhea, poor growth rates, and reduced production. Colonization of humans also is common in some populations (individuals living in village and peri-urban settings in developing countries, recent immigrants from developing countries, homosexual males, and HIV-positive patients), but the spirochete rarely is investigated as a potential human enteric pathogen. In part this is due to its slow growth and specialized growth requirements, meaning that it is not detectable in human fecal samples using routine diagnostic methods. Nevertheless, it has been identified histologically attached to the colon and rectum in patients with conditions such as chronic diarrhea, rectal bleeding, and/or nonspecific abdominal discomfort, and one survey of Australian Aboriginal children showed that colonization was significantly associated with failure to thrive. B. pilosicoli has been detected in the bloodstream of elderly patients or individuals with chronic conditions such as alcoholism and malignancies. This review describes the spirochete and associated diseases. It aims to encourage clinicians and clinical microbiologists to consider B. pilosicoli in their differential diagnoses and to develop and use appropriate diagnostic protocols to identify the spirochete in clinical specimens.

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“…In pigs, Brachyspira-associated disease has been effectively treated with pleuromutilins, macrolides and lincosamides, and carbadox, while metronidazole has been effectively used in people with intestinal spirochetosis (Hampson 2012;Helbling et al 2012). However, the ability to use some of these agents in foodproducing animals is restricted in many jurisdictions; metronidazole is banned for use in food animals in North America and the European Union, and carbadox is banned in Canada, the European Union, and the United Kingdom and recently had its approval rescinded in the United States (FDA 2016).…”

Section: Treatmentmentioning

confidence: 99%

“…In chickens, Brachyspira intermedia and B. pilosicoli are as-sociated with diarrhea, decreased egg production, and fecal staining of eggs (Mappley et al 2014). Finally, human intestinal spirochetosis caused by B. pilosicoli or Brachyspira aalborgi is an infrequent cause of diarrhea most commonly affecting children and immunocompromised individuals (Helbling et al 2012;Tateishi et al 2015).…”

Section: Introductionmentioning

confidence: 99%

A review of the current state of antimicrobial susceptibility test methods forBrachyspira

Kulathunga

Rubin

2017

Can. J. Microbiol.

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Abstract:The re-emergence of swine dysentery (Brachyspira-associated muco-haemorrhagic colitis) since the late 2000s has illuminated diagnostic challenges associated with this genus. The methods used to detect, identify, and characterize Brachyspira from clinical samples have not been standardized, and laboratories frequently rely heavily on in-house techniques. Particularly concerning is the lack of standardized methods for determining and interpreting the antimicrobial susceptibility of Brachyspira spp. The integration of laboratory data into a treatment plan is a critical component of prudent antimicrobial usage. Therefore, the lack of standardized methods is an important limitation to the evidence-based use of antimicrobials. This review will focus on describing the methodological limitations and inconsistencies between current susceptibility testing schemes employed for Brachyspira, provide an overview of what we do know about the susceptibility of these organisms, and suggest future directions to improve and standardize diagnostic strategies.Key words: Brachyspira, susceptibility test, method standardization, veterinary diagnostics, swine dysentery.Résumé : La réémergence de la dysenterie porcine (colite muco-hémorragique associée à Brachyspira) depuis la fin des années 2000 a mis en lumière les défis diagnostiques associés à ce genre. Les méthodes utilisées pour détecter, identifier et caractériser Brachyspira à partir d'échantillons cliniques n'ont jamais été standardisées et les laboratoires dépendent fréquemment et fortement de méthodes maison. L'absence de méthodes standardisées pour déterminer et interpréter la susceptibilité antimicrobienne de Brachyspira spp. est particulièrement inquiétante. L'intégration de données expérimentales à un plan de traitement est une composante importante de l'utilisation avisée d'antimicrobiens, et l'absence de méthodes standardisées constitue conséquemment une limite importante à l'utilisation d'antimicrobiens fondée sur des données probantes. Cette synthèse se concentrera sur la description des limites méthodologiques et des incohérences actuelles qui existent entre les programmes de tests utilisés pour Brachyspira, fournira un exposé général de ce que les auteurs connaissent de la susceptibilité de ces organismes et suggérera des orientations afin d'améliorer et standardiser les stratégies diagnostiques. [Traduit par la Rédaction] Mots-clés : Brachyspira, test de susceptibilité, standardisation de méthodes, diagnostics vétérinaires, dysenterie porcine.

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Intestinal Spirochetosis mimicking inflammatory bowel disease in children

Cited by 19 publications

References 26 publications

Intestinal Bacterial Infection Diagnosed by Histological Examination of Endoscopic Biopsy Specimens

Intestinal Bacterial Infection Diagnosed by Histological Examination of Endoscopic Biopsy Specimens

The Spirochete Brachyspira pilosicoli, Enteric Pathogen of Animals and Humans

A review of the current state of antimicrobial susceptibility test methods forBrachyspira

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