Open AccessSevere Human Intestinal Spirochetosis: An Unusual Cause of Diffuse Colonic Ulcerations in a Patient Living with HIV
Author(s) -
Taiwo Ajose,
Judith Aniekwena,
Valery Effoe,
Melvin Simien
Publication year - 2019
Publication title -
case reports in gastrointestinal medicine
Language(s) - English
Resource type - Journals
eISSN - 2090-6528
pISSN - 2090-6536
DOI - 10.1155/2019/1504079
Subject(s) - medicine , metronidazole , colonoscopy , gastroenterology , human immunodeficiency virus (hiv) , differential diagnosis , diarrhea , colitis , pathology , immunology , antibiotics , colorectal cancer , microbiology and biotechnology , cancer , biology
We describe a case of a homosexual male with human immunodeficiency virus (HIV) and CD4 count of 246 presenting with acute severe bloody diarrhea. Infectious work up was negative, and colonoscopy revealed severe diffuse colonic ulcerations. Histopathologic analysis and Treponemal pallidum immunostaining confirmed the diagnosis of intestinal spirochetosis. There was no evidence of co-infection with other pathogens. His symptoms completely resolved after a 14-day course of metronidazole. This case is notable as colonic ulceration of any severity in patients living with HIV is rarely identified with intestinal spirochetosis. Hence, it should be considered in the differential diagnosis of colonic ulcerations.