[Pulmonary forms of spirochetosis; with reference to an observation of icterohemorrhagic spirochetosis of hemoptysic form].
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Hemoptysis↗
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Intestinal spirochetosis in homosexual men.
Previous studies have demonstrated intestinal spirochetosis in rectal biopsy specimens from 2 to 7 percent of heterosexual and 36 percent of homosexual patients, but the role of intestinal spirochetosis in the pathogenesis of intestinal disease remains unclear. To assess the clinical, histologic, and microbiologic correlates of intestinal spirochetosis in a high-risk group, rectal biopsy specimens from 130 homosexual men, 92 percent of whom had intestinal symptoms, were evaluated. All men were extensively evaluated for rectal and enteric pathogens. Intestinal spirochetosis was identified in rectal biopsy specimens from 39 (30 percent) men; 15 percent of biopsy specimens revealed intestinal spirochetosis on hematoxylin and eosin plus alcian blue staining, and positive results were found in 30 percent on silver staining. No rectal biopsy specimens from 79 control patients with a variety of gastrointestinal symptoms demonstrated evidence of spirochetosis on hematoxylin and eosin, alcian blue, or silver staining (p less than 0.0001). Fifty-six percent of rectal biopsy specimens from men with intestinal spirochetosis were normal, and no specific histologic abnormality was correlated with intestinal spirochetosis. There were no differences in the presence of or type of intestinal symptoms, sigmoidoscopic appearance of the mucosa, type of sexual practice, or prior antibiotic use in men with and without spirochetosis. Other intestinal pathogens were frequent in both groups, and only rectal gonorrhea was significantly associated with intestinal spirochetosis. It is concluded that homosexual men with intestinal symptoms have an increased prevalence of spirochetosis, often in association with Neisseria gonorrhoeae. Independent association of spirochetosis with clinical or histologic findings could not be demonstrated.
Biopsy↗
Intestinal spirochetosis: clinicopathological features with review of the literature.
OBJECTIVE: The purpose of this study is to evaluate the clinical presentation of patients with intestinal spirochetosis, as it is has not been well described in the literature. METHODS: We studied 15 patients with colonic biopsies that showed spirochetosis. The study group consisted of 11 males and 4 females, 10 of the males were heterosexual and one was homosexual. None of these patients were clinically immunocompromized. A colonoscopy was performed for evaluation of different symptoms. The histological diagnosis of spirochetosis was made on H&E examination and confirmed by Giemsa and/or Steiner stain. There was no evidence of associated active or any specific colitis in any of the cases. The control group consisted of 30 patients, 16 males and 14 females that were matched for age and clinical indications for obtaining a colonic biopsy. RESULTS: Colonic mucosa with prominent brush border-like surface colonized with large amounts of spirochetes was noted in all 15 cases in the study group and in none of 30 cases in the control group. The clinical presentation in patients with spirochetosis was compared to the control group. Of the spirochetosis patients 86% presented with some form of clinical symptoms compared with 13% of controls. These symptoms included chronic watery diarrhoea in 40% spirochetosis patients vs 5% in controls; a change in bowel habit was present in 33% of spirochetosis patients vs 3.3% in controls. The endoscopic appearance in spirochetosis patients was reported as normal in six patients, 'polyoid' in seven patients, erythematous in one patient and 'lesion' in one patient. CONCLUSION: These findings suggest that colonic spirochetosis affects a heterogenous group of patients, the majority of whom presented with gastrointestinal symptoms. The variable clinical findings may be related to the infecting organism and the condition may not be harmless in all patients.
Journal Article↗
Venereal spirochetosis of rabbits: epizootiology.
Venereal spirochetosis of rabbits was studied in an enzootically infected conventional rabbit colony. Differences in the susceptibility to and expression of venereal spirochetosis among different inbred or partially inbred strains of rabbits were observed. Significant differences between frequency of lesions in adult male or female rabbits were not observed. Significant differences between the frequency of lesions in breeders or non-breeders were not observed in the 6-12 month age group. However, significant differences between the frequency of lesions in breeders and non-breeders were observed when different ages were pooled. The frequency of venereal spirochetosis in rabbits less than 6 months of age was lower than that in adult rabbits. Newborn fostering experiments indicated that infection occurred at birth and during the suckling period. Evaluation of hysterectomy-derived offspring of infected dams suggested venereal spirochetosis was eliminated by hysterectomy-derivation. Venereal spirochetosis was successfully transmitted by topical or intradermal-subcutaneous genital inoculation of adult rabbits. Adult rabbits were more susceptible to experimental venereal spirochetosis than neonates. The above conclusions were based on clinical and serological observations.
Animals↗
[Test of the effectiveness of tylan on spirochetosis in chickens].
The water-soluble preparation Tylan in conc. 1:2000 in the drinking water for three consecutive days was used successfully against spirochetosis in birds both experimently and in the field practice, as a therapeutic and prophylactic means. 175 (92 per cent) out of 190 affected birds in a spontaneous breakout of spirochetosis recovered. It was found experimentally that Tylan does not interfere with immunogenesis. This made it possible for the authors to vaccinate 10,000 chickens from flocks with manifested spirochetosis along with giving Tylan as a therapeutic and prophylactic agent. Spirochetosis ceased and was no more observed up to the time of slaughter i. e., six months following vaccination. If there are no ticks on the spirochetosis-affected farms it is possible to bring to an end the disease through the therapeutic and prophylactic use of Tylan together with disinfection with 1 per cent sodium hydroxide, no vaccination being needed.
Administration, Oral↗
Appendiceal spirochetosis.
Appendiceal spirochetosis is rarely described in the literature. We assessed the incidence of spirochetosis in a series of 109 appendectomies (76 adult and 33 pediatric cases) done for either suspected acute appendicitis or as a concurrent procedure. Appendiceal spirochetosis was identified on hematoxylin-eosin sections and confirmed by Steiner and Steiner stain and ultrastructural study in two women and two men. One of these four patients was found to have HIV infection. The HIV status of the other three patients was unknown. We observed appendiceal spirochetosis to be an uncommon phenomenon that affects both sexes, occurring with or without symptoms of acute appendicitis. None of our four positive cases occurred in the pediatric age group.
Adolescent↗
Diagnostic examination of human intestinal spirochetosis by fluorescent in situ hybridization for Brachyspira aalborgi, Brachyspira pilosicoli, and other species of the genus Brachyspira (Serpulina).
Human intestinal spirochetosis, characterized by end-on attachment of densely packed spirochetes to the epithelial surface of the large intestines as a fringe has been associated with the weakly beta-hemolytic spirochetes Brachyspira aalborgi and Brachyspira (Serpulina) pilosicoli. In this study, fluorescent in situ hybridization with oligonucleotide probes targeting 16S or 23S rRNA of B. aalborgi, B. pilosicoli, and the genus Brachyspira was applied to 40 sections of formalin-fixed, paraffin-embedded intestinal biopsy specimens from 23 Danish and 15 Norwegian patients with histologic evidence of intestinal spirochetosis. Five biopsy specimens from patients without intestinal spirochetosis and three samples from pigs with experimental B. pilosicoli colitis were examined as well. In addition, the 16S ribosomal DNAs of two clinical isolates of B. aalborgi were sequenced, and a PCR procedure was developed for the identification of B. aalborgi in cultures. The genotypic characteristics of the two clinical isolates showed very high (99.5%) similarity with two existing isolates, the type strain of B. aalborgi and a Swedish isolate. Hybridization with the Brachyspira genus-specific probe revealed a brightly fluorescing fringe of spirochetes on the epithelia of 39 biopsy specimens, whereas 1 biopsy specimen was hybridization negative. The spirochetes in biopsy specimens from 13 Danish and 8 Norwegian patients (55.3%) were identified as B. aalborgi. The spirochetes in the biopsy specimens from the other 17 patients hybridized only with the Brachyspira probe, possibly demonstrating the involvement of as-yet-uncharacterized Brachyspira spirochetes in human intestinal spirochetosis.
Adolescent↗
Colonic spirochetosis in children and adults.
We undertook a retrospective analysis of colonic spirochetosis in 14 cases: females, 3; males, 11; children, 4; adults, 10. Two men had HIV infections. All children and both HIV-infected men had abdominal complaints, diarrhea, or both. Most other adults underwent colonoscopy for polyp screening (n = 4) or follow-up of Crohn disease (n = 1) or had other indications (n = 2) or diarrhea (n = 1). Histologically, spirochetosis was identified in all parts of the colon and was not strongly associated with active inflammation, mucosal injury, or changes of chronicity. Genotype analysis of 13 cases showed that 11 resulted from Brachyspira aalborgi and 2 from Brachyspira pilosicoli infections. Only 2 patients were treated specifically with antibiotics, with complete resolution of abdominal symptoms in 1 patient with follow-up. Follow-up biopsy result were available for 2 patients who did not receive treatment; one showed persistent spirochetosis, and the other was negative. Spirochetosis in this series had a male predominance, was generally caused by B aalborgi, and occurred in 2 distinct clinical settings: children who often have abdominal symptoms and adults who typically are asymptomatic. While treatment information remains limited, treatment can lead to resolution of symptoms in some cases.
Adult↗
Colonic spirochetosis in animals and humans.
Colonic spirochetosis is a disease caused by the gram-negative bacteria Brachyspira aalborgi and Brachyspira pilosicoli. B. pilosicoli induces disease in both humans and animals, whereas B. aalborgi affects only humans and higher primates. Symptoms in humans include diarrhea, rectal bleeding, and abdominal cramps. Colonic spirochetosis is common in third world countries; however, in developed countries, the disease is observed mainly in homosexual males. Terminally ill patients infected with Brachyspira are particularly at risk for developing spirochetemia. Diarrhea, poor growth performance, and decreased feed-to-gain efficiency is seen in pigs with colonic spirochetosis. The disease in chickens is characterized by delayed and/or reduced egg production, diarrhea, poor feed conversion, and retarded growth. Thus, colonic spirochetosis can represent a serious economic loss in the swine and poultry industries. The organisms are transmitted by the fecal-oral route, and several studies have demonstrated that human, primate, pig, dog, or bird strains of B. pilosicoli can be transmitted to pigs, chickens, and mice. B. pilosicoli may be a zoonotic pathogen, and although it has not been demonstrated, there is a possibility that both B. pilosicoli and B. aalborgi can be transferred to humans via contact with the feces of infected animals, meat from infected animals, or food contaminated by food handlers. Neither B. pilosicoli nor B. aalborgi has been well characterized in terms of basic cellular functions, pathogenicity, or genetics. Studies are needed to more thoroughly understand these Brachyspira species and their disease mechanisms.
Animals↗
[Colorectal spirochetosis, a possible but unusual cause of chronic diarrhea?].
INTRODUCTION: Human intestinal spirochetosis has been known since the end of the nineteenth century. OBSERVATION: We report one case of intestinal spirochetosis revealed by chronic diarrhoea and diagnosed on colonic biopsies. The chronic diarrhoea disappeared with antibiotherapy. COMMENTARIES: The prevalence of intestinal spirochetosis in rectal and colonic biopsies, among patients with digestive disorders, varies in occidental countries from 2% to 7%. Presently, the pathogenic role of intestinal spirochetosis is controversial.
Biopsy↗
Congenital spirochetosis in calves: association with epizootic bovine abortion.
Congenital spirochetosis was encountered as a newly recognized infection of cattle. The spirochete was seen in blood of fetuses with lesions of epizootic bovine abortion. A spirochete with morphologic features similar to those found in the fetuses was detected in Ornithodoros coriaceus ticks. Ticks collected from rangelands were allowed to feed on cows that then produced epizootic bovine abortion-affected fetuses, and the fetuses had spirochetosis. Inapparent spirochetosis also was found in fetuses in clinically normal cattle sent to slaughter. Only a few lesions were seen in abattoir-collected fetuses. Fetal spirochetosis was common in the bovine population studied, and it appeared that infection may be limited only by the availability of the tick vector.
Abortion, Veterinary↗
[Intestinal spirochetosis and seronegative spondylarthropathy: association or coincidence?].
Reactive spondylarthropathies include mono- or asymmetrical polyarthritis as well as axial skeletal involvement. Usually they occur after urogenital or gastrointestinal infections caused by Yersinia, Salmonella, Shigella or Campylobacter. Reactive arthritis can also result from infections with other agents. We report the case of a patient with clinical features of seronegative spondylarthropathy. The endoscopic examination revealed intestinal spirochetosis. Other possible arthritogenous agents were ruled out serologically. The pathogenicity of intestinal spirochetosis is controversial. It can be associated with diarrhea. In Western countries the prevalence of intestinal spirochetosis is below 2%, male homosexuals being especially prone to these infections. Spirochetosis is often associated with a mild inflammatory reaction only, while a local increase in IgE plasma cell count has been described.
Arthritis, Reactive↗
[Human intestinal spirochetosis].
Whenever biopsy material obtained from endoscopically normal colorectal mucosa reveals the blue haematoxyphilic line between the microvilli of the covering epithelium, the rare condition of intestinal spirochetosis is diagnosed. The classification of the bacteria detected with the aid of special stains (e.g. the Warthin Starry silver stain) and in the electron microscope, continues to be something of a problem. A further point of contention is the question whether this spirochetal infection is of pathological significance or not. A point mitigating against pathogenicity is the fact that no histological signs of an inflammatory reaction are to be seen. Also, the symptoms of patients with intestinal spirochetosis are such that they provide no basis for a pronouncement on whether the infection is of a pathological or a pathological nature. On the other hand, however, a number of studies do seem to indicate that the spirochetes might be the cause of such symptoms as diarrhoea, constipation and abdominal pain. A point that would appear to support this view is the fact that such symptoms may disappear after successful treatment with metronidazole. The histological diagnosis is easily established when, faced by an apparently normal histological appearance of the colorectal mucosa, the pathologist considers the possibility of spirochetosis, and undertakes a specific search for the blue haematoxyphilic line in the covering epithelium of the colorectal mucosa.
Anti-Bacterial Agents↗
Intestinal spirochetosis of the vermiform appendix.
A series of 681 surgically removed appendices were examined for spirochetes. Five hundred seventy-four appendices were removed because of suspected acute appendicitis; the rest were removed per occasionem. One hundred six of the former were histologically normal, whereas 421 showed acute appendicitis. The remaining 47 specimens showed a variety of other pathological conditions, for example, tumors and diverticula. Spirochetes were found in 13 (12.3%) of the appendices removed from patients clinically suspected to suffer from acute appendicitis, but whose appendices were otherwise histologically normal (pseudoappendicitis). Only 3 patients (0.7%) with histologically confirmed acute appendicitis (p less than 0.05) did show spirochetes in their appendices. Of the 107 patients who had their appendices removed per occasionem, 2 patients (1.9%) had spirochetosis (p less than 0.05). The ultrastructure of the spirochetes obtained from appendices with spirochetosis was studied by means of negative staining and ultrathin sectioning. The morphology of these spirochetes was very similar to that of Brachyspira aalborgi, a spirochete recently isolated from rectal biopsy specimens obtained from patients with colorectal spirochetosis.
Appendectomy↗
Colorectal spirochetosis: clinical significance of the infestation.
Mucosal biopsy specimens from 300 consecutive patients with symptoms requiring sigmoidoscopy were examined for spirochetosis by light and electron microscopy. Colorectal spirochetosis was detected in 15 of the patients (5%). Apart from the spirochetal infestation, the mucosa appeared normal with no inflammatory reaction. The spirochetes were eliminated upon treatment with neomycin and bacitracin, but the symptoms of the patients remained unchanged. It is concluded that in the present material, colorectal spirochetosis was without clinical significance.
Adolescent↗
Venereal spirochetosis of rabbits: eradication.
Venereal spirochetosis of rabbits, caused by Treponema cuniculi, have been observed since the 1940's in the rabbit colony maintained at The Jackson Laboratory. Treatment of individual rabbits with obvious clinical lesions using a product containing crystalline penicillin and dihydrostreptomycin caused lesions to heal but venereal spirochetosis persisted in the colony. Clinical and serological responses of rabbits receiving three subcutaneous injections of benzathine penicillin G-procaine penicillin G (either 42,000 or 84,000 IU/kg body weight/week) at 7 day intervals were monitored. Both doses were effective. Lesions healed within 2 weeks of the first treatment. Rapid plasma reagin titers declined markedly or disappeared by the sixth week after the first treatment. Based upon the above findings and results of previous epizootiological studies, a program to eradicate venereal spirochetosis from this enzootically infected colony was successfully undertaken.
Animals↗
[Production of trivalent vaccine against avian spirochetosis].
Reshetnyak's method was employed to produce a trivalent vaccine against avian spirochetosis, using the serotypes Surnevo I, Pamoukchii, and Venets established in this country. The vaccine was tested for sterility, innocuity, and immunogenicity. Its activity was determined via biologic titration on birds. The vaccine was shown to protect birds against the disease when used at the rate of 0.5 cm3. Six (13.3%) out of all vaccinated birds contracted spirochetosis within various periods following vaccination. It was found that the duration of postvaccinal immunity after treatment with the trivalent vaccine lasted eight months (the time of observation). The vaccine protected 86.7% of the treated birds against spirochetosis.
Animals↗
Invasive intestinal spirochetosis: a report of three cases.
We here report on three patients with gastrointestinal symptoms in whom spirochetes were found in colonic biopsies. The patients, heterosexual adults, were not immunocompromised. Electron microscopy was performed on colonic biopsies from each of the three patients. Apart from the basophilic band consisting of spirochetes, the mucosa was normal in two patients on light microscopy and showed mild inflammation in the other one. However on electron microscopy there was invasion of the colonic epithelial cells, macrophages, goblet cells and Schwann cells by spirochetes, and stunting of the microvilli. The spirochetes conformed to the morphology of Brachyspira aalborgi, and no other infective etiology or pathology could be identified in these patients to account for their symptoms. Since the clinical significance of intestinal spirochetosis is uncertain, antibiotics were not administered to any of the three patients and all three improved symptomatically with non-specific treatment. Intestinal spirochetosis, previously thought to be non-invasive and non-pathogenic in humans, may be invasive and may be the cause of gastrointestinal symptoms in some patients.
Adult↗