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[Intestinal spirochetosis in homosexuals infected with HIV. 3 cases]
A Lafeuillade1, E Delbeke, T Benderitter
1Service de Médecine Interne et Hématologie, Hôpital Chalucet, Toulon.
Abstract:
We report 3 cases of intestinal spirochetosis in homosexuals infected with the human immunodeficiency virus (2 group III and 1 group IV C1, according to the Centers for Disease Control classification) presenting with moderate, chronic diarrhea. The diagnosis was made based on the histological examination of colorectal biopsies showing a layer of spirochetes carpeting the epithelium. Electron microscopy evaluation and culturing of the microorganism provided information on the bacterium's morphology. Metronidazole effectively treated the diarrhea. Intestinal spirochetes, whose existence has been recognized for more than a century, constitute a heterogeneous group of bacteria whose pathogenic role in man remains controversial. The systemic search for these organisms in a large series of patients would help to situate their place among the various etiologies of infectious diarrhea in immunodepressed subjects.
Insights
Three cases of human immunodeficiency virus-infected homosexual men with chronic diarrhea were diagnosed with intestinal spirochetosis. Metronidazole effectively treated the condition, suggesting its therapeutic potential.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Intestinal spirochetosis is a controversial cause of diarrhea.
- Human immunodeficiency virus (HIV) infection can alter gut immunity.
- Homosexual men are a population at risk for HIV and opportunistic infections.
Observation:
- Three homosexual men with HIV infection presented with chronic diarrhea.
- Colorectal biopsies revealed a dense layer of spirochetes on the epithelium.
- Electron microscopy and culturing provided bacterial morphology details.
Findings:
- Diagnosis of intestinal spirochetosis was confirmed histologically.
- Metronidazole treatment was effective in resolving diarrhea.
- Spirochetes were identified as the causative agent in these cases.
Implications:
- This study highlights intestinal spirochetosis as a potential cause of chronic diarrhea in HIV-infected individuals.
- Metronidazole shows promise as an effective treatment for this condition.
- Further research is needed to understand the role of spirochetes in infectious diarrhea among immunocompromised patients.