Department of Pathology, Sir H. N. Reliance Foundation Hospital and Research Centre, IndiaFulltext PDF
Forty-six-year male from India presented with 2-year history of small volume non bloody diarrhea with mild abdominal pain. He had no history of fever or constitutional symptoms and only minimal weight loss. His blood evaluation showed mild iron deficiency anemia with normal serum albumin and renal profile. Routine stool examination showed no blood, pus cells, ova or parasites. Celiac serology was negative. Contrast enhanced CT (Computed Tomography) abdomen showed subcentimetric mesenteric lymph nodes, bowel was normal in size and thickness. Upper GI endoscopy was normal with normal duodenal biopsy; Ileocolonoscopy showed few aphthous ulcers in terminal ileum with mild nodularity. Ileal biopsies showed bluish filamentous structure on surface epithelium forming a thick false brush border appearance, suggestive of intestinal spirochetosis. Rest of ileal architecture was well preserved. Patient was commenced on cyclical antibiotics including Nitazoxanide, Metronidazole, doxycycline and Rifaximin. Patient on follow up showed improvement in symptoms and weight gain. Intestinal spirochetosis is commonly transmitted to human from infected animals. Our patient was butcher by occupation. Our case is an interesting presentation of Intestinal Spirochetosis in form of chronic diarrhea.
Spirochetosis; Chronic diarrhea; False brush border
Joshi H. Intestinal Spirochetosis: An Interesting Cause of Chronic Diarrhea. Ann Infect Dis Epidemiol. 2021; 6(1): 1063.