Human Intestinal Spirochetosis: A Rare Case of Intermittent Bloating and Hematochezia

Moux, Reinaldo L Pérez; Mude, Pooja; Doshi, Shreyans; Madwani, Kiran; Barrett, Amanda; Yap, John Erikson L.

doi:10.7759/cureus.25756

Cited by 2 publications

(14 citation statements)

References 13 publications

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“…32 We have shown that intestinal spirochaetosis in MSM is associated with other STIs, namely Neisseria gonorrhoea, Chlamydia trachomatis, Treponema pallidum, Shigella flexneri and HSV2, either concomitant, or a previous infection. 7,12,14,17,22,25 The increased prevalence of intestinal spirochaetosis in MSM with other STIs could be biological; a synergistic effect of multiple infections causing symptoms. For example, STIs altering mucosal integrity may provide an optimal environment for intestinal spirochaetosis, but evidence for this is limited.…”

Section: Discussionmentioning

confidence: 99%

“…This review has identified some possible biological and behavioural factors associated intestinal spirochaetosis Our review suggests that HIV serostatus is associated with intestinal spirochaetosis in MSM. 7,16,[20][21][22][23][24][25] People living with HIV often live in dense urban populations and are part of large sexual networks of MSM which can contribute to other, wider structural determinants of health in transmission of intestinal spirochaetosis in MSM. 28 The association with HIV status is likely to be complex; a direct biological immunosuppressive effect on mucosal immune-reactive cells by HIV has been suggested, providing an environment for spirochaetes to invade mucosal epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…The predominant clinical symptom of intestinal spirochaetosis in MSM was diarrhoea and some reported mucus and/or rectal blood or bleeding. 7,[12][13][14][15]17,[20][21][22][23][24][25][26][27] MSM also presented with non-specific gastrointestinal symptoms, abdominal pain, vomiting, constitutional symptoms including night sweats, rash and weakness, rectal symptoms including rectal pain, rectal discharge, flatulence and tenesmus. 7,[12][13][14][15][16][17][21][22][23][24][25][26][27]…”

Section: Clinical Presentationsmentioning

confidence: 99%

“…The manuscripts were from Europe (n = 7), North America (n = 5), South America (n = 1) and Australia (n = 2) and included case reports (n = 6), case series (n = 4) and cross-sectional studies (n = 5). 7,[12][13][14][15][16][17][20][21][22][23][24][25][26][27] Altogether there were 188 individual MSM with intestinal spirochaetosis included in this review. We identified both biological and behavioural factors and were able to characterize specific presenting symptoms associated with intestinal spirochaetosis in MSM (Tables 2 and 3).…”

Section: R E Su Ltsmentioning

confidence: 99%

“…MSM living with HIV was associated with intestinal spirochaetosis including some individuals with low CD4 counts (<200 cells/mL). 7,16,[20][21][22][23][24][25] Having a concomitant sexually transmitted infection (STI) including: Neisseria gonorrheae, Chlamydia trachomatis, early syphilis, Shigella flexneri, Campylobacter spp. and herpes simplex virus type II (HSV2); or having a previous history of an STI, were associated with intestinal spirochaetosis in MSM.…”

Section: Biological Factorsmentioning

confidence: 99%

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Factors and presenting symptoms associated with intestinal spirochaetosis in men who have sex with men: A systematic review

Rabuszko,

Chessell,

Llewellyn

et al. 2023

Acad Dermatol Venereol

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The transmission dynamics and presenting symptoms of intestinal spirochaetosis (Brachyspira pilosicoli, Brachyspira aalborgi) are poorly understood but is seen more frequently in men who have sex with men (MSM) where sexual transmission may occur. We aimed to systemically review the literature to define the factors and presenting symptoms associated with intestinal spirochaetosis in MSM. We systematically searched three bibliographical databases (MEDLINE, EMBASE and Scopus) for manuscripts written in English up to November 2022. The primary author conducted an initial screen and three authors conducted independent reviews to determine the final eligible manuscripts. We only included manuscripts where there were specific data on factors and presenting symptoms associated with intestinal spirochaetosis in MSM. Fifteen manuscripts published between 1981 and 2022 met the inclusion criteria that included 188 MSM. Sexually transmitted intestinal spirochaetosis in MSM was associated with—living with HIV (including having a low CD4 count <200 mm3), having a concomitant sexually transmitted infection, a history of a sexually transmitted infection, co‐infection with intestinal parasites; and sexual behaviour including oro‐anal sexual contact, oro‐genital contact, fisting, condom‐less anal sex, receptive anal sex, multiple non‐regular sexual partners and increased number of lifetime sexual partners. The presenting symptoms of MSM with intestinal spirochaetosis were diarrhoea, abdominal pain, constitutional symptoms and proctitis, including rectal pain, rectal bleeding rectal discharge, flatulence and tenesmus. We have highlighted some biological and behavioural factors and presenting symptoms associated with intestinal spirochaetosis in MSM which provide insight for clinicians, guidelines and future public health control strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Presentationsmentioning

confidence: 99%

Section: R E Su Ltsmentioning

confidence: 99%

Section: Biological Factorsmentioning

confidence: 99%

See 3 more Smart Citations

Factors and presenting symptoms associated with intestinal spirochaetosis in men who have sex with men: A systematic review

Rabuszko,

Chessell,

Llewellyn

et al. 2023

Acad Dermatol Venereol

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Intestinal Spirochetosis and Chronic Diarrhea: A Case Report and Literature Review

Novick,

Berhanu,

Negassi

et al. 2023

Cureus

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Spirochetosis is a rare condition characterized by the presence of spirochetes in the gastrointestinal tract. It is typically associated with immunodeficiency. We present a case of chronic watery diarrhea in a 48-year-old housewife who had a 12-week history of variable-volume bowel movements without blood or mucus, accompanied by a sense of urgency. Chronic diarrhea led to weight loss and fatigue, significantly impacting her quality of life. Despite the absence of known risk factors, a comprehensive clinical evaluation and exclusion of other potential causes prompted a rectosigmoid biopsy, which revealed distinctive histological findings of spirochetosis. This case underscores the significance of considering spirochetosis as a differential diagnosis in cases of chronic watery diarrhea, even in the absence of immunodeficiency. The utilization of rectosigmoid biopsy and careful histopathological examination played a pivotal role in establishing an accurate diagnosis.

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Human Intestinal Spirochetosis: A Rare Case of Intermittent Bloating and Hematochezia

Cited by 2 publications

References 13 publications

Factors and presenting symptoms associated with intestinal spirochaetosis in men who have sex with men: A systematic review

Factors and presenting symptoms associated with intestinal spirochaetosis in men who have sex with men: A systematic review

Intestinal Spirochetosis and Chronic Diarrhea: A Case Report and Literature Review

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