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M9650998.TXT
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1996-03-30
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Document 0998
DOCN M9650998
TI Invasive colitis and hepatitis due to previously uncharacterized
spirochetes in patients with advanced human immunodeficiency virus
infection.
DT 9505
AU Kostman JR; Patel M; Catalano E; Camacho J; Hoffpauir J; DiNubile MJ;
Department of Medicine, Cooper Hospital/University Medical; Center,
University of Medicine and Dentistry of New Jersey/Robert; Wood Johnson
Medical School, Camden, USA.
SO Clin Infect Dis. 1995 Nov;21(5):1159-65. Unique Identifier : AIDSLINE
MED/96125997
AB We describe three patients with advanced human immunodeficiency virus
(HIV) infection, two with colitis and one with cholestatic hepatitis,
for whom results of detailed endoscopic and histologic studies were
suggestive of invasive spirochetosis. In the two patients with colitis,
colonoscopic evaluation revealed either diffuse ulcerations or pustules;
in both cases, there was histologic evidence of extensive superficial
cell necrosis and infiltration of the mucosa and lamina propria with
acute inflammatory cells. Spirochetes in the mucosa and crypts were
visualized by Warthin-Starry silver staining. Morphologically similar
spirochetes throughout the liver specimen from the patient with
cholestatic hepatitis were demonstrated by Warthin-Starry silver
staining. Analysis with electron microscopy revealed these organisms to
be loosely coiled spirochetes. Despite extensive evaluation, no other
pathogens were identified. Invasive spirochetal infection, as defined by
the results of Warthin-Starry silver staining of involved tissues,
should be considered in the differential diagnosis of patients with HIV
infection who have otherwise unexplained colitis or cholestatic
hepatitis.
DE Adult AIDS-Related Opportunistic Infections/*COMPLICATIONS/DIAGNOSIS/
MICROBIOLOGY Case Report
Cholestasis/*COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY
Colitis/*COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY Diagnosis, Differential
Female Hepatitis/*COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY Human Male
Microscopy, Electron Spirochaetales/ISOLATION & PURIF/ULTRASTRUCTURE
Spirochaetales Infections/*COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).