Intestinal Spirochetosis mimicking inflammatory bowel disease in children

BMC Pediatrics

Andreas Nydegger⁴  Katia Jaton²  Bernard Vaudaux¹  Maria-Chiara Osterheld³  Rossana Helbling⁴ 

[1] Pediatric Infectious Disease Unit, Department of Pediatrics, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland;Institute of Microbiology, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 48, CH-1011, Lausanne, Switzerland;Institute of Pathology, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 48, CH-1011, Lausanne, Switzerland;Pediatric Gastroenterology Unit, Department of Pediatrics, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland

关键词: Inflammatory bowel disease;    Brachyspira pilosicoli;    Brachyspira aalborgi;    Intestinal spirochetosis;   

Others  :  1170631
DOI  :  10.1186/1471-2431-12-163

 received in 2012-07-06, accepted in 2012-10-08,  发布年份 2012

【 摘 要 】

Background

Intestinal spirochetosis is an unusual infection in children and its clinical significance in humans is uncertain. The presence of these microorganisms in humans is well-known since the late 1800’s and was first described in 1967 by Harland and Lee by electron microscopy.

Case presentation

This article reports the findings of one pediatric case, review of the current literature, and an overview of therapeutic options.

Conclusion

A high degree of suspicion is required in cases presenting with abdominal pain, chronic diarrhoea and/or hematochezia associated with a normal endoscopic examination, thus emphasizing the importance of multiple biopsies throughout the colon.

【 授权许可】

   
2012 Helbling et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Tsinganou E, Gebbers JO: Human intestinal spirochetosis--a review. German medical science: GMS e-journal 2010, 8:Doc01.
• [2]van Mook WN, Koek GH, van der Ven AJ, Ceelen TL, Bos RP: Human intestinal spirochaetosis: any clinical significance? Eur J Gastroenterol Hepatol 2004, 16(1):83-87.
• [3]Harland WA, Lee FD: Intestinal spirochaetosis. British Medical Journal 1967, 3(5567):718-719.
• [4]Nielsen RH, Orholm M, Pedersen JO, Hovind-Hougen K, Teglbjaerg PS, Thaysen EH: Colorectal spirochetosis: clinical significance of the infestation. Gastroenterology 1983, 85(1):62-67.
• [5]da Cunha-Ferreira RM, Phillips AD, Stevens CR, Hudson MJ, Rees HC, Walker-Smith JA: Intestinal spirochaetosis in children. J Pediatr Gastroenterol Nutr 1993, 17(3):333-336.
• [6]White J, Roche D, Chan YF, Mitchell EA: Intestinal spirochetosis in children: report of two cases. Pediatric pathology / affiliated with the International Paediatric Pathology Association 1994, 14(2):191-199.
• [7]Heine RG, Ward PB, Mikosza AS, Bennett-Wood V, Robins-Browne RM, Hampson DJ: Brachyspira aalborgi infection in four Australian children. J Gastroenterol Hepatol 2001, 16(8):872-875.
• [8]Marthinsen L, Willen R, Carlen B, Lindberg E, Varendh G: Intestinal spirochetosis in eight pediatric patients from Southern Sweden. APMIS: Acta Pathologica, Microbiologica, et immunologica Scandinavica 2002, 110(7–8):571-579.
• [9]Nodit L, Parizhskaya M: Intestinal spirochetosis. Arch Pathol Lab Med 2004, 128(7):823-824.
• [10]King NR, Fidda N, Gourley G: Colorectal spirochetosis in a child with rectal bleeding: case report and literature review. J Pediatr Gastroenterol Nutr 2005, 41(5):673-675.
• [11]Calderaro A, Bommezzadri S, Gorrini C, Piccolo G, Peruzzi S, Villanacci V, Zambelli C, Dettori G, Chezzi C: Infective colitis associated with human intestinal spirochetosis. J Gastroenterol Hepatol 2007, 22(11):1772-1779.
• [12]Carpentieri DF, Souza-Morones S, Gardetto JS, Ross HM, Downey K, Ingebo K, Siaw E: Intestinal spirochetosis in children: five new cases and a 20-year review of the literature. Pediatr Dev Pathol 2010, 13(6):471-475.
• [13]Paster BJ, Dewhirst FE: Phylogenetic foundation of spirochetes. J Mol Microbiol Biotechnol 2000, 2(4):341-344.
• [14]Hovind-Hougen K, Birch-Andersen A, Henrik-Nielsen R, Orholm M, Pedersen JO, Teglbjaerg PS, Thaysen EH: Intestinal spirochetosis: morphological characterization and cultivation of the spirochete Brachyspira aalborgi gen. nov., sp. nov. J Clin Microbiol 1982, 16(6):1127-1136.
• [15]Hampson DJ, Oxberry SL, La T: Potential for zoonotic transmission of Brachyspira pilosicoli. Emerg Infect Dis 2006, 12(5):869-870.
• [16]Bruckner DA, Colonna P: Nomenclature for aerobic and facultative bacteria. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America 1997, 25(1):1-10.
• [17]Mikosza AS, La T, de Boer WB, Hampson DJ: Comparative prevalences of Brachyspira aalborgi and Brachyspira (Serpulina) pilosicoli as etiologic agents of histologically identified intestinal spirochetosis in Australia. J Clin Microbiol 2001, 39(1):347-350.
• [18]Bait-Merabet L, Thille A, Legrand P, Brun-Buisson C, Cattoir V: Brachyspira pilosicoli bloodstream infections: case report and review of the literature. Ann Clin Microbiol Antimicrob 2008, 7:19. BioMed Central Full Text
• [19]Calderaro A, Gorrini C, Peruzzi S, Piccolo G, Dettori G, Chezzi C: Occurrence of human intestinal spirochetosis in comparison with infections by other enteropathogenic agents in an area of the Northern Italy. Diagn Microbiol Infect Dis 2007, 59(2):157-163.
• [20]Brooke CJ, Hampson DJ, Riley TV: In vitro antimicrobial susceptibility of Brachyspira pilosicoli isolates from humans. Antimicrob Agents Chemother 2003, 47(7):2354-2357.
• [21]Law CL, Grierson JM, Stevens SM: Rectal spirochaetosis in homosexual men: the association with sexual practices, HIV infection and enteric flora. Genitourinary Medicine 1994, 70(1):26-29.
• [22]Tanahashi J, Daa T, Gamachi A, Kashima K, Kondoh Y, Yada N, Yokoyama S: Human intestinal spirochetosis in Japan; its incidence, clinicopathologic features, and genotypic identification. Modern pathology: an official journal of the United States and Canadian Academy of Pathology, Inc 2008, 21(2):76-84.
• [23]Carr NJ, Mahajan H, Tan KL, Sharma R: The histological features of intestinal spirochetosis in a series of 113 patients. Int J Surg Pathol 2010, 18(2):144-148.
• [24]Peruzzi S, Gorrini C, Piccolo G, Calderaro A, Dettori G, Chezzi C: Human intestinal spirochaetosis in Parma: a focus on a selected population during 2002–2005. Acta bio-medica: Atenei Parmensis 2007, 78(2):128-132.
• [25]Korner M, Gebbers JO: Clinical significance of human intestinal spirochetosis–a morphologic approach. Infection 2003, 31(5):341-349.
• [26]Yang M, Lapham R: Appendiceal spirochetosis. Southern Medical Journal 1997, 90(1):30-32.
• [27]Alsaigh N, Fogt F: Intestinal spirochetosis: clinicopathological features with review of the literature. Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland 2002, 4(2):97-100.
• [28]Schmiedel D, Epple HJ, Loddenkemper C, Ignatius R, Wagner J, Hammer B, Petrich A, Stein H, Gobel UB, Schneider T, et al.: Rapid and accurate diagnosis of human intestinal spirochetosis by fluorescence in situ hybridization. J Clin Microbiol 2009, 47(5):1393-1401.
• [29]Antonakopoulos G, Newman J, Wilkinson M: Intestinal spirochaetosis: an electron microscopic study of an unusual case. Histopathology 1982, 6(4):477-488.