Padmanabhan V, Dahlstrom J, Maxwell L, Kaye G, Clarke A, Barratt P J
Department of Anatomical Pathology, Woden Valley Hospital, Garran, ACT.
Pathology. 1996 Aug;28(3):283-6. doi: 10.1080/00313029600169174.
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.
我们在此报告三例有胃肠道症状的患者，在其结肠活检中发现了螺旋体。这些患者为成年异性恋者，无免疫功能低下情况。对这三名患者的结肠活检组织进行了电子显微镜检查。在光学显微镜下，除了由螺旋体组成的嗜碱性带外，两名患者的黏膜正常，另一名患者显示轻度炎症。然而，在电子显微镜下，螺旋体侵入了结肠上皮细胞、巨噬细胞、杯状细胞和施万细胞，并使微绒毛发育不良。这些螺旋体符合奥尔堡短螺旋体的形态，在这些患者中未发现其他感染病因或病理情况来解释他们的症状。由于肠道螺旋体病的临床意义尚不确定，这三名患者均未使用抗生素，所有三名患者经非特异性治疗后症状均有改善。肠道螺旋体病以前被认为在人类中无侵袭性且无致病性，但可能具有侵袭性，并且可能是一些患者胃肠道症状的原因。
