INVASIVE INTESTINAL SPIROCHETOSIS - A REPORT OF 3 CASES

We here report on three patients with gastrointestinal symptoms in who m spirochetes were found in colonic biopsies. The patients, heterosexu al adults, were not immunocompromised. Electron microscopy was perform ed on colonic biopsies from each of the three patients. Apart from the basophilic band consisting of spirochetes, the mucosa was normal in t wo patients on light microscopy and showed mild inflammation in the ot her one. However on electron microscopy there was invasion of the colo nic epithelial cells, macrophages, goblet cells and Schwann cells by s pirochetes, and stunting of the microvilli. The spirochetes conformed to the morphology of Brachyspira aalborgi, and no other infective etio logy or pathology could be identified in these patients to account for their symptoms. Since the clinical significance of intestinal spiroch etosis is uncertain, antibiotics were not administered to any of the t hree patients and all three improved symptomatically with non-specific treatment. Intestinal spirochetosis, previously thought to he non-inv asive and non-pathogenic in humans, may be invasive and may be the cau se of gastrointestinal symptoms in some patients.