Clinicopathologic study of intestinal spirochetosis in Japan with special reference to human immunodeficiency virus infection status and species types: analysis of 5265 consecutive colorectal biopsies
Open Access
- 13 January 2015
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 15 (1), 1-5
- https://doi.org/10.1186/s12879-014-0736-4
Abstract
Previous studies reported that the incidence of intestinal spirochetosis was high in homosexual men, especially those with Human Immunodeficiency Virus infection. The aim of the present study was to clarify the clinicopathological features of intestinal spirochetosis in Japan with special reference to Human Immunodeficiency Virus infection status and species types. A pathology database search for intestinal spirochetosis was performed at Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital between January 2008 and October 2011, and included 5265 consecutive colorectal biopsies from 4254 patients. After patient identification, a retrospective review of endoscopic records and clinical information was performed. All pathology slides were reviewed by two pathologists. The length of the spirochetes was measured using a digital microscope. Causative species were identified by polymerase chain reaction. Intestinal spirochetosis was diagnosed in 3 out of 55 Human Immunodeficiency Virus-positive patients (5.5%). The mean length of intestinal spirochetes was 8.5 μm (range 7–11). Brachyspira pilosicoli was detected by polymerase chain reaction in all 3 patients. Intestinal spirochetosis was also diagnosed in 73 out of 4199 Human Immunodeficiency Virus-negative patients (1.7%). The mean length of intestinal spirochetes was 3.5 μm (range 2–8). The species of intestinal spirochetosis was identified by polymerase chain reaction in 31 Human Immunodeficiency Virus-negative patients. Brachyspira aalborgi was detected in 24 cases (78%) and Brachyspira pilosicoli in 6 cases (19%). Both Brachyspira aalborgi and Brachyspira pilosicoli were detected in only one Human Immunodeficiency Virus-negative patient (3%). The mean length of Brachyspira aalborgi was 3.8 μm, while that of Brachyspira pilosicoli was 5.5 μm. The length of Brachyspira pilosicoli was significantly longer than that of Brachyspira aalborgi (p < 0.01). The lengths of intestinal spirochetes were significantly longer in Human Immunodeficiency Virus-positive patients than in Human Immunodeficiency Virus-negative patients (p < 0.05). The incidence of intestinal spirochetosis was slightly higher in Human Immunodeficiency Virus-positive patients than in Human Immunodeficiency Virus-negative patients. However, no relationship was found between the Human Immunodeficiency Virus status and intestinal spirochetosis in Japan. Brachyspira pilosicoli infection may be more common in Human Immunodeficiency Virus-positive patients with intestinal spirochetosis than in Human Immunodeficiency Virus-negative patients with intestinal spirochetosis.Keywords
This publication has 23 references indexed in Scilit:
- Intestinal Spirochetosis: An Enigmatic DiseaseDigestive Diseases and Sciences, 2012
- The Histological Features of Intestinal Spirochetosis in a Series of 113 PatientsInternational Journal of Surgical Pathology, 2008
- Human intestinal spirochetosis in Japan; its incidence, clinicopathologic features, and genotypic identificationLaboratory Investigation, 2008
- Infective colitis associated with human intestinal spirochetosisJournal of Gastroenterology and Hepatology, 2007
- Intestinal spirochetosis and chronic watery diarrhea: Clinical and histological response to treatment and long‐term follow upJournal of Gastroenterology and Hepatology, 2006
- Analysis of genetic variation in Brachyspira aalborgi and related spirochaetes determined by partial sequencing of the 16S rRNA and NADH oxidase genesJournal of Medical Microbiology, 2004
- Colonic Spirochetosis in Children and AdultsAmerican Journal of Clinical Pathology, 2003
- Intestinal SpirochetesAmerican Journal of Clinical Pathology, 2003
- Intestinal Spirochetes Organisms in Search of a Disease?American Journal of Clinical Pathology, 2003
- Rectal spirochaetosis in homosexual men: the association with sexual practices, HIV infection and enteric flora.Sexually Transmitted Infections, 1994