Intestinal spirochetosis: first cases reported in Brazil and the use of immunohistochemistry as an aid in histopathological diagnosis Espiroquetose intestinal: primeiros casos no Brasil e o uso de técnicas imunohistoquímicas como ajuda no diagnóstico histopatológico

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: T. de Brito, Marina P. Sandoval, Ana G. Silva, R. C. Saad, W. Colaiacovo
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1996
• Subjects: Intestinal Spirochetosis; Brachyspira aalborgi; Immunohistochemistry; Anti-leptospiral and anti-treponemal sera; Antigen detection; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Urna
• Online Access: https://doi.org/10.1590/S0036-46651996000100009; https://doaj.org/article/614d2e73a9214439b76fd99d34f2d7ba

Colonization of the colon and rectum by intestinal spirochetes is detected for the first time in Brazil in 4 of 282 (1.41%) patients who had undergone sigmoidoscopy and/or colonoscopy with a histopathological diagnosis of chronic non specific-colitis. This frequency is probably understimated, since surgically obtained specimens were not considered in the present study. Histopathological diagnosis was performed using routine stains like hematoxylin-eosin which showed the typical, of 3-µm thick hematoxyphilic fringe on the brush border of the surface epithelium, and by silver stains like the Warthin-Starry stain. Immunohistochemical procedures using two, polyclonal, primary antibodies, one against Treponema pallidum and the other against Leptospira interrogans serovar copenhageni serogroup Icterohaemorrhagiae cross-reacted with spirochetal antigen/s producing a marked contrast of the fringe over the colonic epithelium, preserving the spiral-shaped morphology of the parasite. In one case with marked diarrhea, immunohistochemistry detected spirochetal antigen/s within a cell in an intestinal crypt, thus demonstrating that the infection can be more widely disseminated than suspected using routine stains. Immunohistochemical procedures, thus, greatly facilitate the histological diagnosis of intestinal spirochetosis and may contribute to a better understanding of the pathogenesis of the disease. Transmission and scanning electron microscopy performed in one case showed that the spirochete closely resembled the species designated as Brachyspira aalborgi. A colonização do colo e reto por espiroquetas intestinais foi detectada pela primeira vez no Brasil em 4 de 282 (1,41%) pacientes submetidos a sigmoidoscopia e/ou colonoscopia com o diagnóstico histopatológico de colite crônica inespecífica. A frequência é provavelmente menor que a real, urna vez que espécimens cirúrgicos não foram considerados no presente estudo. O diagnóstico histopatológico foi feito através de colorações de rotina, tais como a hematoxilina-eosina, ...