title: Human intestinal spirochetosis in an immunocompromised host: evaluation of eradication therapy by endoscopy, histopathology and bacteriology.
abstract: Human intestinal spirochetosis (HIS) is a colorectal infectious disease caused by Brachyspira species. We describe HIS in an immunocompromised, 62-year-old Japanese man who presented at Jichi Medical University Hospital with symptoms of diarrhea and bloody stool. He had rheumatoid arthritis that had been treated with immunosuppressive drugs for 10 years. Colonoscopy revealed multiple erythematous spots in the cecum and colon. A histopathological examination identified intestinal colonization by spirochetes, and Brachyspira pilosicoli was isolated from biopsy specimens, indicating a diagnosis of HIS. Metronidazole eradicated the spirochetes, the intestinal mucosa recovered to normal, and the clinical symptoms disappeared. This case suggests that it is important to keep in mind HIS in the differential diagnosis of immunocompromised patients with chronic diarrhea and bloody stool.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Takezawa
authors.affiliation: Division of Bacteriology, Department of Infection and Immunity, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. shunhaya@jichi.ac.jp.
authors.forename: Shunji
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Animal Health Laboratory, School of Agriculture, Ibaraki University, 3-21-1 Ami, Ibaraki, 300-0393, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Adachi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sunada
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Nishimura
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Miyata
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Division of Bacteriology, Department of Infection and Immunity, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hirai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
keywords: Antibiotic susceptibility test; Brachyspira pilosicoli; Human intestinal spirochetosis; Immunocompromised host