Incidental diagnosis of intestinal spirochetosis in a patient with chronic hepatitis B:A case report  

作　　者：Samantha Novotny Joseph Mizrahi Eric U Yee Michael J Clores 

机构地区：[1]Renaissance School of Medicine,Stony Brook University,Stony Brook,NY 11794,United States [2]Division of Gastroenterology and Hepatology,Stony Brook Medicine,Stony Brook,NY 11794,United States [3]Department of Pathology,Stony Brook Medicine,Stony Brook,NY 11794,United States

出　　处：《World Journal of Clinical Infectious Diseases》2022年第2期69-75,共7页世界临床传染病学杂志

摘　　要：BACKGROUND Intestinal spirochetosis(IS)is caused by Brachyspira colonization of the gastrointestinal tract.Some patients are asymptomatic,while others present with gastrointestinal complaints such as abdominal pain,diarrhea,or gastrointestinal bleeding.However,the clinical significance of asymptomatic IS is unclear,and guidelines are lacking regarding decision to treat.CASE SUMMARY A 73-year-old male with peptic ulcer disease and gastroesophageal reflux was evaluated for elevated liver enzymes.He was diagnosed with chronic hepatitis B virus and prescribed entecavir.Additionally,he was leukopenic and had stage 4 liver fibrosis on transient elastography.After 5 mo,the patient returned for esophagogastroduodenoscopy and screening colonoscopy.He denied any gastrointestinal symptoms at that time.Findings included grade I distal esophageal varices,mild portal hypertensive gastropathy,and patchy nodular gastric antral mucosa.On colonoscopy,several polyps were removed.Hematoxylin and eosin stain of mucosa adjacent to the polyps revealed a“false brush border,”and Steiner stain identified spirochetes adherent to the mucosa.These pathology findings confirmed the diagnosis of IS.He was managed conservatively with careful observation and without antibiotic therapy via a multidisciplinary approach between gastroenterology and infectious disease.He remained asymptomatic at the 7-wk follow-up.CONCLUSION This case reports the finding of incidental,asymptomatic IS in a leukopenic patient with hepatitis B virus. Conservative management was appropriate.

关 键 词：Intestinal spirochetosis Hepatitis B COLONOSCOPY HISTOLOGY LEUKOPENIA Case report 

分 类 号：R57[医药卫生—消化系统]