Human intestinal spirochetosis mimicking ulcerative colitis

被引：21

作者：

Nishii S. ^{[1
]}

Higashiyama M. ^{[1
]}

Ogata S. ^{[2
]}

Komoto S. ^{[1
]}

Ito S. ^{[1
]}

Mizoguchi A. ^{[1
]}

Terada H. ^{[1
]}

Furuhashi H. ^{[1
]}

Takajo T. ^{[1
]}

Shirakabe K. ^{[1
]}

Watanabe C. ^{[1
]}

Tomita K. ^{[1
]}

Nagao S. ^{[1
]}

Miura S. ^{[1
]}

Hokari R. ^{[1
]}

机构：

[1] Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, 359-8513, Saitama

[2] Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa

来源：

Clinical Journal of Gastroenterology | 2018年 / 11卷 / 2期

关键词：

Colonoscopic findings; Human intestinal spirochetosis; Imprint cytology; Infectious colitis; Ulcerative colitis;

D O I：

10.1007/s12328-017-0807-3

中图分类号：

学科分类号：

摘要：

Human intestinal spirochetosis (HIS) is a colorectal infection caused by the Brachyspira species of intestinal spirochetes, whose pathogenicity in humans remains unclear owing to the lack of or mild symptoms. We monitored the 5-year clinical course of a woman diagnosed with HIS in whom ulcerative colitis (UC) had been suspected. Following a positive fecal occult blood test, she underwent a colonoscopic examination at a local clinic where she was diagnosed with “right-sided” UC concomitant with incidentally detected HIS, and was referred to our hospital. Colonoscopic, histopathological, and cytological examination revealed localized erosive colitis in the ascending and the right transverse colon concomitant with HIS resembling skip lesions of UC. Initially, we chose the wait-and-watch approach; however, she gradually developed bloody diarrhea. Metronidazole improved her abdominal symptoms, as well as her colonoscopic and histopathological findings, suggesting that HIS was responsible for her colorectal inflammation. This case reveals (1) a possible pro-inflammatory role of HIS, (2) difficulties in diagnosing HIS in chronic proctocolitis, and (3) a possible inclusion of some HIS cases in “UC”. HIS could mimic UC and might be included in differential diagnoses for UC. Antibiotic administration is necessary following the detection of HIS, particularly in patients demonstrating an atypical presentation of UC. © 2017, Japanese Society of Gastroenterology.

引用

页码：145 / 149

页数：4

共 19 条

[1]

Korner M., Gebbers J.-O., Clinical significance of human intestinal spirochetosis—a morphologic approach, Infection, 31, pp. 341-349, (2003)

[2]

van Mook W.N.K.A., Koek G.H., van der Ven A.J.A.M., Et al., Human intestinal spirochaetosis: any clinical significance?, Eur J Gastroenterol Hepatol, 16, pp. 83-87, (2004)

[3]

Harland W.A., Lee F.D., Intestinal spirochaetosis, Br Med J, 3, pp. 718-719, (1967)

[4]

Weisheit B., Bethke B., Stolte M., Human intestinal spirochetosis: analysis of the symptoms of 209 patients, Scand J Gastroenterol, 42, pp. 1422-1427, (2007)

[5]

Calderaro A., Bommezzadri S., Gorrini C., Et al., Infective colitis associated with human intestinal spirochetosis, J Gastroenterol Hepatol, 22, pp. 1772-1779, (2007)

[6]

Calderaro A., Villanacci V., Conter M., Et al., Rapid detection and identification of Brachyspira aalborgi from rectal biopsies and faeces of a patient, Res Microbiol, 154, pp. 145-153, (2003)

[7]

Ooi C.J., Fock K.M., Makharia G.K., Et al., The Asia–Pacific consensus on ulcerative colitis, J Gastroenterol Hepatol, 25, pp. 453-468, (2010)

[8]

Ogata S., Higashiyama M., Adachi Y., Et al., Imprint cytology detects floating Brachyspira in human intestinal spirochetosis, Hum Pathol, 41, pp. 249-254, (2010)

[9]

Niihara N., Ogata S., Ohara I., Et al., Staining technique in imprint cytology of intestinal spirochetes from endoscopic biopsy samples, Brachyspira, 3, pp. 38-43, (2012)

[10]

Naresh R., Song Y., Hampson D.J., The intestinal spirochete Brachyspira pilosicoli attaches to cultured Caco-2 cells and induces pathological changes, PLoS One, 4, (2009)

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