From: Intestinal Spirochetosis mimicking inflammatory bowel disease in children
Ref. | Age (y) | Sex | Signs and Symptoms | Endoscopic findings | Histologic findings | Treatment | Comments |
---|---|---|---|---|---|---|---|
[5] | 6 | F | Rectal bleeding, abdominal pain, pruritus ani | Normal | IS and mild inflammation | Piperazine | Improvement |
2 | M | Intermittent bloody diarrhoea | Distal colitis | IS and mild to moderate infiltration with inflammatory cells | Mebendazole (Ascaris in stool) | Improvement | |
13 | M | Recurrent fever, abdominal pain, joint pain, mouth and penile ulcers | Normal | IS and mild patchy inflammation | No treatment | No follow-up information | |
[6] | 7.5 | M | Periumbilical pain, frequent bloody stools, urgency, poor appetite and weight loss | Mild rectal granularity | IS | 1) Metronidazole | Persistence of diarrhea; eradication on endoscopicfollow-up at 6 months |
2) Neomycine | |||||||
8 | F | Acute abdominal pain, vomiting and fever | Not done | IS in resected appendix | No treatment | Improvement | |
[7] | 12 | M | Intermittent vomiting, diarrhoea, weight loss, headaches and fatigue | Normal | IS and mild focal colitis | Metronidazole and Amoxicillin (7 days) | Improvement |
12 | M | Recurrent abdominal pain | Normal | IS and mild focal cryptitis in the caecum | 1) Penicillin V and Metronidazole (7 days) | Persistence of symptoms and IS; after second course of Metronidazole eradication and improvement | |
2) Metrodidazole (800mg 3x/d for 7 days) | |||||||
16 | F | Recurrent colicky right upper quadrant pain | Normal | IS | Metronidazole and Amoxicillin (10 days) | Improvement | |
9 | F | Intermittent diarrhoea and rectal bleeding | Normal | IS | Metronidazole and Amoxicillin (10 days) | Improvement | |
[8] | 5 | F | Abdominal pain, diarrhoea and rectal bleeding | Rectal oedema and enterobiasis | IS | Erythromycin (40mg/kg/d for 10 days) | Rectal bleeding ceased but abdominal pain recurred, no follow-up |
7 | M | Abdominal pain and diarrhoea | Slight proctitis | IS | Doxycycline (200mg day1, then 100mg/d for 8 days ) | Persistence of abdominal pain despite endoscopic eradication | |
4 | F | Mucus and bloody stools | Proctitis, juvenile polyp | IS | Clarithromycin (50mg/kg/d for 10 days) | Improvement | |
10 | F | Diarrhoea and rectal bleeding | Rectal hyperaemic membranes | IS | Clarithromycin | Improvement | |
13 | M | Abdominal pain, nausea and weight loss | Slight inflammation of rectum | IS and HP- positive gastritis | 1) Clarithromycin and Amoxicillin | Persistence of IS, eradication after Clarithromycin and Metronidazole | |
2) Clarithromycin and Metronidazole (500mg 2x/d and 400mg 3x/d 7 days) | |||||||
8 | M | Recurrent abdominal pain | Juvenile polyp | IS and low-grade chronic inflammation | 1) Penicillin V | Improvement after Erythromycin | |
2) Erythromycin (40-50mg/kg/d for 10 days) | |||||||
15 | F | Abdominal pain and rectal bleeding | Normal | IS | Clarithromycin (500mg 2x/d for 14 days) | Improvement but persistence of rectal bleeding; absence of IS on follow-up rectoscopy | |
14 | F | Abdominal pain | Normal | IS | Metronidazole (400mg 3x/d for 10 days) | No improvement; absence of IS on follow-up colonoscopy | |
[9] | 9 | M | Recurrent abdominal pain, diarrhea and rectal bleeding | Mild erythema of rectal mucosa | IS and hypereosinophilia | Erythromycin (40mg/kg/d for 10 days) | Improvement |
[10] | 9 | M | Rectal bleeding, diarrhea, tenesmus, flatulence and weight loss | Normal | IS and mild epithelial reactive changes | No treatment | Improvement |
[11] | 4 | F | Abdominal discomfort, rectal bleeding and weight loss | Mucosal erosions, hyperemia, 2 juvenile polyps | IS and inflammatory infiltrate | Metronidazole | Improvement |
[12] | 11 | F | Intermittent abdominal pain and rectal bleeding | Normal | IS | 1)Metronidazole (250mg 3x/d) | No improvement, additional course of Metronidazole and Vancomycin with persistence of IS, no follow-up information |
2) Metronidazole (1000mg/d for 2 months and 750 mg/d for 14 days) | |||||||
3) Vancomycin (7 days) | |||||||
6 | M | Stomach cramps, rectal bleeding, intermittent diarrhea, rectal prolapse | Normal | IS | Metronidazole (250mg 2x/d) | Improvement, but alternating constipation with watery diarrhea and rectal prolapse | |
17 | F | Recurrent abdominal pain, nausea, vomiting | Normal | IS and mild eosinophilic inflammatory infiltrate | No treatment | No follow-up information | |
11 | F | Right lower quadrant pain | Not done | Appendicitis and IS in resected appendix | Cefoxitin (30mg/kg/dose, 4 doses) | No follow-up information | |
10 | M | Periumbilical and epigastric pain, nausea, fever | Not done | Appendicitis and IS in resected appendix | No treatment | No follow-up information |