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Diagnostic Pathology
Published in: Diagnostic Pathology 1/2018

Open Access 01-12-2018 | Research

Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

Authors: Rondell P. Graham, Bita V. Naini, Sejal S. Shah, Christina A. Arnold, Rajesh Kannangai, Michael S. Torbenson, Dora M. Lam-Himlin

Published in: Diagnostic Pathology | Issue 1/2018

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Abstract

Background

Human intestinal spirochetosis (IS) has been recognized for decades, but whether it represents commensalism or a pathogenic process remains controversial. IS is diagnosed on routine stains with confirmation by silver stains but these stains are labor intensive and slow to read. We evaluated the Treponema pallidum immunostain as a diagnostic adjunct for IS.

Methods

We retrieved biopsies from 33 patients with IS for this study. Each case was tested by Warthin-Starry (WS) and T. pallidum immunohistochemistry (IHC). Species specific genotyping was performed in 3 cases.

Results

Patients with IS ranged from 22 to 82 years without gender predilection. IS involved normal (n = 15), and inflamed (n = 5) mucosa and colonic polyps (n = 13). Warthin-Starry and T. pallidum IHC were positive in all cases including both species of Brachyspira. Six (18%) symptomatic patients were treated for IS, and experienced resolution. In patients diagnosed with incidental IS on cancer screening (n = 5), follow up biopsies, without therapy, were negative for IS. T. pallidum IHC required 75 min less hands-on time than WS for performance and was faster to interpret.

Conclusions

T. pallidum IHC can be used to confirm the diagnosis of IS and is easier to perform and faster to interpret than WS.
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Metadata
Title
Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis
Authors
Rondell P. Graham
Bita V. Naini
Sejal S. Shah
Christina A. Arnold
Rajesh Kannangai
Michael S. Torbenson
Dora M. Lam-Himlin
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2018
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/s13000-017-0676-6

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