An Uncommon Cause of Diarrhoea and the Importance of an Internist Approach
  • Filipa Brás Monteiro
    Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
  • Sofia Cristóvão Ferreira
    Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Instituto Português de Oncologia, Lisbon
  • Rita Mendes
    Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon

Abstract

Background: Human intestinal spirochetosis is a condition defined by the presence of spirochetes attached to the colonic epithelium. Brachyspira aalborgi and Brachyspira pilosicoli may cause the disease in humans.

Case report: We describe the case of a 58-year-old patient who presented with epigastric abdominal pain and diarrhoea. He was thought to be having a myocardial infarction and underwent an angiogram with subsequent stenting of the circumflex coronary artery. However, the pain and diarrhoea were still present after the procedure and the patient now had sepsis. An exploratory laparotomy was inconclusive. The patient improved on intravenous antibiotics and was discharged, but returned to the emergency department 2 days later with the same complaints. He was then admitted to an internal medicine ward where the diagnosis of intestinal spirochetosis was made. The patient was started on metronidazol and completed a 10-day antibiotic course with full recovery of his symptoms.

Conclusion: This case highlights the importance of an internist-based approach that could have prevented two invasive procedures and the accompanying risks.

VIEW THE ENTIRE ARTICLE

References

  • Harland WA, Lee FD. Intestinal spirochaetosis. BMJ1967;3:718–719.
  • Tateishi Y, Takahashi M, Horiguchi S, Funata N, Koizumi K, Okudela K, et al. Clinicopathologic study of intestinal spirochetosis in Japan with special reference to human immunodeficiency virus infection status and species types: analysis of 5265 consecutive colorectal biopsies. BMC Infect Dis 2015;15:13.
  • Iwamoto J, Ogata S, Honda A, Saito Y, Murakami M, Ikegami T, et al. Human intestinal spirochaetosis in two ulcerative colitis patients. Intern Med 2014;53:2067–2071.
  • Weisheit B, Bethke B, Stolte M. Human intestinal spirochetosis: analysis of the symptoms of 209 patients. Scand J Gastroenterol 2007;42:1422–1427.
  • Efstathia T, Jan-Olaf G. Human intestinal spirochetosis – a review. Ger Med Sci 2010;8:Doc01.

    • Views: 1146
    HTML downloads: 466
    PDF downloads: 390
    Untitled downloads: 0
    word downloads: 0
    word manuscript downloads: 0

    Published: 2017-03-27
    Issue: Vol. 4 No. 2 (view)

    How to cite:
    1.
    Monteiro FB, Ferreira SC, Mendes R. An Uncommon Cause of Diarrhoea and the Importance of an Internist Approach. EJCRIM 2017;4 doi:10.12890/2016_000501.