Medicina Digestiva, Hospital Francesc de Borja , España.
Medicina Digestiva, Hospital Francesc de Borja, España.
Rev Esp Enferm Dig. 2024 Oct;116(10):564-565. doi: 10.17235/reed.2024.10621/2024.
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.
我们呈现了 4 例肠道螺旋体病的临床病例。第一例表现为慢性腹泻，在随机活检中检测到螺旋体。第二例是同性恋者，HIV+，出现直肠出血，结肠镜检查显示直溃疡，螺旋体活检显示阴性梅毒 PCR。第三例也是同性恋者，HIV+，无症状，偶然发现螺旋体病。最后一例也是一位无病变的非活动溃疡性结肠炎患者的偶然组织学诊断。肠道螺旋体病似乎通过性传播和食用受污染的水传播。大多数是无症状病例，但可能导致病变，包括溃疡和症状。仅推荐在有症状或免疫抑制的患者中进行治疗。必须与梅毒螺旋体引起的病变区分开来。
