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[Severe diarrhoea with invasive intestinal spirochaetosis].
Ned Tijdschr Geneeskd. 2005 Dec 17; 149(51):2873-6.NT

Abstract

A 38-year-old heterosexual male presented with a 6 to 7 week history of severe diarrhoea but no other complaints. In routine faecal cultures and routine parasitological investigations no pathogenic micro-organisms were observed. Colonoscopy revealed a normal mucosa. Multiple biopsies were obtained. The histological diagnosis was invasive intestinal spirochaetosis. The immunostain for Borrelia burgdorferi cross-reacted with the spirochetes of the intestinal spirochaetosis. After two weeks of incubation under strict anaerobic conditions a spirochaete was cultured from a biopsy of the sigmoid mucosa. The 16SrDNA sequence was consistent with Brachyspira aalborgi. The HIV and syphilis results were negative. The patient was treated first with metronidazole and then by clindamycin. The diarrhoea subsided after the second course of treatment and the cause was presumed to have been the invasive intestinal spirochaetosis. Intestinal spirochaetosis is usually found coincidentally at histological examination of colon biopsies. There is no general consensus that intestinal spirochaetosis is the cause of the diarrhoea. There is however an association between the presence of symptoms and the invasivity of spirochaetes, morphological colon epithelial changes and evidence of immune response. The literature reports patients who improve symptomatically without specific treatment. Treatment may be given to patients with severe symptoms.

Authors+Show Affiliations

Universiteit Maastricht, Faculteit der Geneeskunde, Maastricht.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

dut

PubMed ID

16398171

Citation

Koopmans, N G., et al. "[Severe Diarrhoea With Invasive Intestinal Spirochaetosis]." Nederlands Tijdschrift Voor Geneeskunde, vol. 149, no. 51, 2005, pp. 2873-6.
Koopmans NG, Kwee WS, Grave W, et al. [Severe diarrhoea with invasive intestinal spirochaetosis]. Ned Tijdschr Geneeskd. 2005;149(51):2873-6.
Koopmans, N. G., Kwee, W. S., Grave, W., & Stals, F. S. (2005). [Severe diarrhoea with invasive intestinal spirochaetosis]. Nederlands Tijdschrift Voor Geneeskunde, 149(51), 2873-6.
Koopmans NG, et al. [Severe Diarrhoea With Invasive Intestinal Spirochaetosis]. Ned Tijdschr Geneeskd. 2005 Dec 17;149(51):2873-6. PubMed PMID: 16398171.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Severe diarrhoea with invasive intestinal spirochaetosis]. AU - Koopmans,N G, AU - Kwee,W S, AU - Grave,W, AU - Stals,F S, PY - 2006/1/10/pubmed PY - 2006/2/24/medline PY - 2006/1/10/entrez SP - 2873 EP - 6 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 149 IS - 51 N2 - A 38-year-old heterosexual male presented with a 6 to 7 week history of severe diarrhoea but no other complaints. In routine faecal cultures and routine parasitological investigations no pathogenic micro-organisms were observed. Colonoscopy revealed a normal mucosa. Multiple biopsies were obtained. The histological diagnosis was invasive intestinal spirochaetosis. The immunostain for Borrelia burgdorferi cross-reacted with the spirochetes of the intestinal spirochaetosis. After two weeks of incubation under strict anaerobic conditions a spirochaete was cultured from a biopsy of the sigmoid mucosa. The 16SrDNA sequence was consistent with Brachyspira aalborgi. The HIV and syphilis results were negative. The patient was treated first with metronidazole and then by clindamycin. The diarrhoea subsided after the second course of treatment and the cause was presumed to have been the invasive intestinal spirochaetosis. Intestinal spirochaetosis is usually found coincidentally at histological examination of colon biopsies. There is no general consensus that intestinal spirochaetosis is the cause of the diarrhoea. There is however an association between the presence of symptoms and the invasivity of spirochaetes, morphological colon epithelial changes and evidence of immune response. The literature reports patients who improve symptomatically without specific treatment. Treatment may be given to patients with severe symptoms. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/16398171/[Severe_diarrhoea_with_invasive_intestinal_spirochaetosis]_ DB - PRIME DP - Unbound Medicine ER -