Year 2024 / Volume 116 / Number 10
Letter
Intestinal spirochetosis: four cases with different clinical presentations

564-565

DOI: 10.17235/reed.2024.10621/2024

Carlos Boix Clemente, Clara Navarro Peiró, Beatriz Moreno Torres, Gloria Alemany Pérez, María Dolores Pérez Zahonero, Pablo Olcina Domínguez, Lidia Martí Romero, Lara González González,

Abstract
We present 4 clinical cases of intestinal spirochetosis. The first one presents with chronic diarrhea, and spirochetes are detected in random biopsies. The second is homosexual, HIV+, presents rectal bleeding, colonoscopy shows a straight ulcer and spirochete biopsies show negative treponema PCR. The third was also homosexual, HIV+, asymptomatic, with a chance finding of spirochetosis. The last case is also a chance histological diagnosis in a patient with inactive ulcerative colitis without lesions. Intestinal spirochetosis appears to be transmitted sexually and by consumption of contaminated water. The majority are asymptomatic cases but could cause lesions including ulcerations and symptoms. Treatment is only recommended in symptomatic or immunosuppressed patients. It must be distinguished from lesions caused by Treponema pallidum.
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References
1- Esteve M, Salas A, Fernández-Bañares F, et al. Intestinal spirochetosis and chronic watery diarrhea: Clinical and histological response to treatment and long-term follow up. J Gastroenterol Hepatol. 2006; 21(8): 1326–1333.
2- Garcia-Hernandez D, Vall-Mayans M, Coll-Estrada S, et al. Human intestinal spirochetosis, a sexually transmissible infection? Review of six cases from two sexually transmitted infection centres in Barcelona. International Journal of STD & AIDS. 2021; 32(1): 52-58.
3- Fan K, Eslick GD, Nair PM, et al. Human intestinal spirochetosis, irritable bowel syndrome, and colonic polyps: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022; 37(7): 1222-1234.
4- Norris SJ. Hiding in Plain Sight: Colonic Spirochetosis in Humans. J Bacteriol. 2019; 201(21): e00465-19.
5- Cárdenas Villa RD, Lozzi RD, Román HO, et al. Cat scratch lesions as a manifestation of chronic colitis due to spirochetosis. Rev Esp Enferm Dig. 2022; 114(11): 693-694.
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Citation tools
Boix Clemente C, Navarro Peiró C, Moreno Torres B, Alemany Pérez G, Pérez Zahonero M, Olcina Domínguez P, et all. Intestinal spirochetosis: four cases with different clinical presentations. 10621/2024


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Publication history

Received: 29/06/2024

Accepted: 06/07/2024

Online First: 01/08/2024

Published: 09/10/2024

Article Online First time: 33 days

Article editing time: 102 days


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