Discussion:

Human intestinal spirochetosis (IS) is a condition defined by the presence of spirochetal microorganisms attached to the apical cell membrane of the colorectal epithelium. In humans, Brachyspira aalborgi and Brachyspira pilosicoli predominate. Prevalence rates of IS are negatively correlated with living standards and are high in homosexuals and HIV-infected individuals.

Most of the cases are incidental findings. However, Symptomatic IS is most commonly accompanied by complaints of watery diarrhea and vague abdominal pain without other apparent cause. The diagnosis of IS is base on the histological appearance of a diffuse blue fringe, approximately 3 to 6 μm thick, along the border of the intercryptal epithelial layer. This finding is referred to as the “false brush border.”

There are relatively little data published on recommended treatments.