case_images: PMC10904080_01
case_images: Intestinal spirochetosis as visualized on a colonic biopsy specimen. A. Hematoxylin and eosin stain shows a purple, fuzzy "false-brush border" on luminal epithelial cells (arrows) in a colon biopsy specimen. B. Warthin-starry silver stain highlights the bacterial organisms as a black, fuzzy line covering the luminal epithelial cells (arrows).
case_images: cureus-0016-00000053248-i01.jpg
case_images: PMC10904080_01_cureus-0016-00000053248-i01.jpg
case_images: FIG1
case_images: A positive Warthin-Starry (WS) silver stain confirmed the diagnosis of IS (Figure 1).
case_images: PMC10904080_02
case_images: Intestinal spirochetosis in a rectal biopsy. A. Hematoxylin and eosin stain with a false-brush border on luminal epithelial cells (arrow). B. Warthin-starry silver stain highlighting the bacterial organisms (arrow).
case_images: cureus-0016-00000053248-i02.jpg
case_images: PMC10904080_02_cureus-0016-00000053248-i02.jpg
case_images: FIG2
case_images: Multiple biopsies were taken, and the characteristic false brush border was visualized on histology from the descending colon and rectal biopsies, confirmed to be IS by WS silver stain (Figure 2).
case_images: PMC10904080_03
case_images: Intestinal spirochetosis seen in a patient with ulcerative colitis. A. Hematoxylin and eosin stain with faint, fuzzy appearance on the surface of luminal epithelial cells (arrows). B. Warthin-starry silver stain highlighting diffuse involvement by spirochetes (arrow).
case_images: cureus-0016-00000053248-i03.jpg
case_images: PMC10904080_03_cureus-0016-00000053248-i03.jpg
case_images: FIG3
case_images: Ascending and sigmoid colon biopsies were negative for active colitis, however, significant for the presence of IS, confirmed by WS silver stain (Figure 3).