1/31. brachyspira aalborgi infection diagnosed by culture and 16S ribosomal dna sequencing using human colonic biopsy specimens. In this study we report on the isolation and characterization of the intestinal spirochete brachyspira aalborgi using human mucosal biopsy specimens taken from the colon of a young adult male with intestinal spirochetosis. A selective medium, containing 400 microg of spectinomycin/ml and 5 microg of polymyxin/ml was used for the isolation procedure. A high degree of similarity, in terms of phenotypic properties and 16S ribosomal dna sequence, was observed between the isolated strain, named W1, and the type strain, 513A, of B. aalborgi. A similarity of 99.7% in the nucleotide sequence was found between W1 and 513A(T), based on the almost-complete gene. A short segment of the 16S rRNA gene was amplified by PCR using genetic material enriched from paraffin-embedded biopsy specimens, which were taken from the patient on two occasions. The products showed 16S rRNA gene sequences virtually identical to that of strain 513A(T) in the actual region. immunohistochemistry was performed on the colonic biopsy specimens with a polyclonal antibody raised against an intestinal spirochete isolated in a previous case of human intestinal spirochetosis. The antibody reacted strongly with the spirochete on the luminal epithelium. No immune reaction was seen within or below the surface epithelium. Routine histology did not reveal signs of colitis. Electron microscopy showed spirochetes attached end-on to the colonic mucosal surface. The isolate grew poorly on a commonly used selective medium for intestinal spirochetes, which may explain previous failures to isolate B. aalborgi. ( info) |
2/31. Colorectal spirochetosis. Colorectal spirochetosis is a very rare pathologic condition that was been described several decades ago; however, its clinical significance is debatable in causing problems to human beings. We describe the first 2 documented cases of colorectal sprirochetosis in saudi arabia and discuss the different views about this entity and it's clinical significance. ( info) |
3/31. brachyspira aalborgi infection in four Australian children. AIM: The clinical presentation of four children and adolescents (two males and two females with a mean age of 12.4 years; range 9-16 years) with colorectal spirochetosis is discussed. RESULTS: Symptoms included persistent diarrhea (n = 2), rectal bleeding (n = 1) and abdominal pain (n = 2). In all patients, colorectal spirochetosis was an unanticipated finding on colonic histology, and the presence of spirochetes was confirmed by the use of electron microscopy. Spirochetes were identified as brachyspira aalborgi by using PCR amplification of the bacterial 16S rRNA and nicotinamide adenine dinucleotide oxidase sequences in all four patients. No other enteric pathogens were found. CONCLUSIONS: Although all patients appeared to respond to antibiotic treatment, the clinical significance of B. aalborgi as a human pathogen requires further investigation. ( info) |
4/31. brachyspira (Serpulina) pilosicoli spirochetemia in an immunocompromised patient. The case of an elderly immunocompromised man with non-Hodgkin's lymphoma who presented with fever, abdominal pain and bloody diarrhea is described. brachyspira pilosicoli was isolated from culture. The patient was treated with penicillin g i.v. and became afebrile. B. pilosicoli is a recently recognized enteric pathogen of humans and animals. Intestinal spirochetosis should be included in the differential diagnosis of any immunocompromised or critically ill patient with dysentery. ( info) |
5/31. Intestinal spirochetosis in eight pediatric patients from Southern sweden. Intestinal spirochetes in humans have been recognized for more than a century, but it is still a matter of debate whether they are just commensal organisms or whether they cause colorectal disease. Most descriptions to date are of adult patients, while reports in the pediatric literature have been scarce. In a retrospective study we found eight children with intestinal spirochetosis. The findings, clinical as well as pathological, with light- and electron microscopy, are presented. In all patients, a 3 microm-thick layer of spirochetes was visualised on the luminal aspect of the epithelial cells covering the enterocytes and part of the gland openings. In five of the eight cases an inflammatory cell reaction was seen by light microscopy and in one patient a picture suggesting intracytoplasmatically located spirochetes was seen by electron microscopy. Despite partial or complete destruction of microvilli, spirochetes were still able to adhere to the enterocyte membranes. In three children there was a clear correlation between treatment and relief of symptoms. In four there was partial improvement and in one child no change in bowel-related symptoms. We believe that intestinal spirochetes may cause colorectal disease in children. Possible pathogenic mechanisms are discussed. ( info) |
6/31. Rapid detection and identification of brachyspira aalborgi from rectal biopsies and faeces of a patient. This study reports for the first time the detection of brachyspira aalborgi in faeces and rectal biopsies of a female suffering for 3-4 months of abdominal pain with long-standing mucosal diarrhoea, rectal bleeding and suspected carcinoma of the rectum. After pre-treatment of samples (faeces and biopsies) with a liquid medium (trypticase soy broth-TSB) containing foetal calf serum (FCS, 10%) and spectinomycin and rifampicin (TSB-SR) the first detection of B. aalborgi isolate HBS1 was observed after 48 h in the primary plates of selective blood agar modified medium (BAM) containing spectinomycin and rifampicin (BAM-SR), where growth zones were signalled by a small weakly beta-haemolytic halo. Attempts to subculture spirochaetes in agar media failed. The new HBS1 isolate was only propagated in TSB broth and at electron microscopy it showed 4 endoflagella inserted at each tapered end. The phenotypic characterization of HBS1 demonstrated absence of hippurate hydrolysis, indole production, alpha-galactosidase, alpha- and beta-glucosidase activities in accordance with the B. aalborgi type strain. Rapid identification of B. aalborgi isolate HBS1 was performed directly from faeces and rectal biopsies and subsequently from pure cultures by a genetic method based on 16S dna restriction fragment length polymorphism (RFLP)-polymerase chain reaction (PCR). The sequence of 16S dna amplicon of the isolate HBS1 was found 99.2% corresponding to that of the B. aalborgi type strain. Our results encourage further investigations for the development of a suitable selective agar medium for the isolating and cultivating B. aalborgi from human specimens. ( info) |
7/31. Intestinal spirochetosis: a poorly understood infection causing chronic diarrhea. A young man with chronic diarrhea for many years underwent extensive evaluation. Finally, based on multiple colonic mucosal biopsies from near-normal appearing mucosa, the cause was elucidated to be spirochetosis. This is an enigmatic condition where the spirochetes seem to attach to the epithelial lining of the small and large bowel, without significant underlying inflammation. Because of this reason, there is controversy whether it is a true diarrheal pathogen. Suggested treatments are discussed. ( info) |
8/31. Fusospirochetosis causing necrotic oral ulcers in patients with hiv infection. Under certain permissive circumstances, normally occurring fusiform bacteria and borrelia spirochetes can result in a symbiotic overgrowth that leads to necrotic oral ulcers (stomatitis), gingivitis, and periodontitis. These lesions are collectively known as oral fusospirochetosis and may be under-appreciated in patients with hiv infection and AIDS. Fusospirochetal oral ulcers in patients with hiv are often large, necrotic, and malodorous; they respond completely to penicillin. We report 3 patients with hiv infection and fusospirochetal ulcerative stomatitis and review the clinical presentation, microbiologic diagnosis, potential pathogenesis, and treatment of these lesions. ( info) |
9/31. Intestinal spirochaetosis: a rare histopathological diagnosis and potential light microscopic pitfall. A case of intestinal spirochaetosis is described. Endoscopic specimens of a 52-year-old female revealed a blue basophilic margin of mucosal surface in haematoxylin-eosin stained sections. However, on ultrastructural level, moderate infestation of enterocytic brush border with spirochaetes was found. The pitfalls of histopathological diagnosis of spirochaetosis are discussed. ( info) |
10/31. Intestinal spirochetosis and colon diverticulosis. A case of intestinal spirochetosis in a 62-year-old white male is reported. The condition was characterized by chronic flatulence and episodes of intestinal hemorrhage, in addition to the evidence of hypotonic diverticular disease, with a large number of slender organisms in the colon epithelium and cryptae. Spirochetes were demonstrated by Whartin-Starry stain. The serologic tests for syphilis and hiv were positive. Spirochetosis was treated with penicillin g, and the patient remains free of intestinal complaints 20 months later. ( info) |