{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:55:39Z","timestamp":1781495739216,"version":"3.54.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Intestinal spirochetosis (IS) is infrequently identified in about 1% of human colonic biopsy specimens. On routine sections, it is diagnosed by identifying a thick band of basophilia on the apical surface of colonic mucosa. Intestinal spirochetosis is caused by Brachyspira pilosicoli and Brachyspira aalborgi, but whether it represents a commensalism or a pathogenic process remains debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 175 cases of IS diagnosed at our institution over a 10-year period. The clinicopathologic features were reviewed using hematoxylin and eosin (H&amp;E)\u2013stained slides, along with the results from histochemical and immunohistochemical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All cases were diagnosed by colonoscopic biopsy, except for 1 case. Indications for colonoscopy were unexplained diarrhea (48.6%), colorectal cancer screening (36%), rectal bleeding (6.3%), abdominal pain (4%), follow-up for ulcerative colitis (4%), Crohn disease (0.6%), and constipation (0.6%). Associated significant clinical conditions included HIV-positive status (14.3%), diabetes mellitus (1.7%), post\u2013liver transplant (0.6%), retroperitoneal liposarcoma (0.6%), prostate cancer (0.6%), and Kaposi sarcoma (0.6%). Pathologic changes in background colonic mucosa included unremarkable (89%), active inflammation (6%), hyperplastic polyp (1.7%), tubular adenoma (1.7%), and Trichuris trichiura infestation (0.6%). On H&amp;E, all cases had the characteristic basophilic hue on the epithelial surface of colonic mucosa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intestinal spirochetosis in our study had a striking male predominance and affected both immunocompetent and immunosuppressed individuals. Nearly two-thirds of the patients were symptomatic, indicating that IS is likely a pathogenic infection of low virulence. Histologically, IS can involve normal, inflamed, and dysplastic epithelium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqag069","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T11:34:58Z","timestamp":1779622498000},"source":"Crossref","is-referenced-by-count":0,"title":["Intestinal spirochetosis in the modern era: a decade-long clinicopathologic study"],"prefix":"10.1093","volume":"165","author":[{"given":"Poojaben","family":"Dhorajiya","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Kansas Health System , Kansas City, KS,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansi","family":"Singal","sequence":"additional","affiliation":[{"name":"Department of Pathology, ESIC Medical College , Joka, Kolkata, West 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