Human intestinal spirochetosis presenting as colonic ulceration in an immunocompetent 65-year-old man.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-06-12 DOI:10.1007/s15010-025-02574-0

Sara Zotti, Lisa Fusaro, Stefano Di Bella, Stella Babich

{"title":"Human intestinal spirochetosis presenting as colonic ulceration in an immunocompetent 65-year-old man.","authors":"Sara Zotti, Lisa Fusaro, Stefano Di Bella, Stella Babich","doi":"10.1007/s15010-025-02574-0","DOIUrl":null,"url":null,"abstract":"Purpose: To report an unusual case of symptomatic human intestinal spirochetosis (HIS) in an immunocompetent individual without known risk factors, and a potential zoonotic source (domestic pig).Methods: A 65-year-old heterosexual man with no gastrointestinal or immunological history presented with acute diarrhea, abdominal pain, vomiting, and rectal bleeding. Colonoscopy revealed two ulcers in the distal transverse colon; biopsies were taken from ulcerated and normal mucosa. Histopathology included Warthin-Starry staining.Results: Histology showed dense spirochetal colonization forming a \"false brush border,\" consistent with HIS. The ileum was unremarkable. The patient was treated with oral metronidazole 500 mg q6h for 10 days, resulting in complete resolution of symptoms. Follow-up colonoscopy at 13 months confirmed full mucosal healing, and the patient remained asymptomatic.Conclusion: This case highlights the possible pathogenic role of HIS in gastrointestinal symptoms and colonic ulceration, even in immunocompetent individuals without traditional risk factors. It underscores the diagnostic value of histology in atypical colonic lesions and suggests zoonotic transmission as a plausible route of infection outside classical risk groups.","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s15010-025-02574-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To report an unusual case of symptomatic human intestinal spirochetosis (HIS) in an immunocompetent individual without known risk factors, and a potential zoonotic source (domestic pig).

Methods: A 65-year-old heterosexual man with no gastrointestinal or immunological history presented with acute diarrhea, abdominal pain, vomiting, and rectal bleeding. Colonoscopy revealed two ulcers in the distal transverse colon; biopsies were taken from ulcerated and normal mucosa. Histopathology included Warthin-Starry staining.

Results: Histology showed dense spirochetal colonization forming a "false brush border," consistent with HIS. The ileum was unremarkable. The patient was treated with oral metronidazole 500 mg q6h for 10 days, resulting in complete resolution of symptoms. Follow-up colonoscopy at 13 months confirmed full mucosal healing, and the patient remained asymptomatic.

Conclusion: This case highlights the possible pathogenic role of HIS in gastrointestinal symptoms and colonic ulceration, even in immunocompetent individuals without traditional risk factors. It underscores the diagnostic value of histology in atypical colonic lesions and suggests zoonotic transmission as a plausible route of infection outside classical risk groups.

查看原文本刊更多论文

人类肠道螺旋体病表现为结肠溃疡，免疫功能正常的65岁男性。

目的：报告一例罕见的有症状的人肠道螺旋体病（HIS）病例，该病例发生在一名免疫功能正常的个体中，没有已知的危险因素，潜在的人畜共患病源（家猪）。方法：65岁异性恋男性，无胃肠道或免疫史，以急性腹泻、腹痛、呕吐、直肠出血为主。结肠镜检查显示远端横结肠有两个溃疡；从溃疡和正常粘膜上取活检。组织病理学包括Warthin-Starry染色。结果：组织学显示密集的螺旋体定植形成“假刷状边界”，与HIS一致。回肠没有什么特别的。患者口服甲硝唑500 mg q6h治疗10天，症状完全缓解。随访13个月结肠镜检查证实粘膜完全愈合，患者无症状。结论：本病例强调了HIS在胃肠道症状和结肠溃疡中可能的致病作用，即使在没有传统危险因素的免疫正常个体中也是如此。它强调了非典型结肠病变的组织学诊断价值，并提示人畜共患传播是经典危险人群之外的一种可能的感染途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.