Chronic diarrhea secondary to intestinal spirochetosis, should we think about it?

Abstract

Abstract Human intestinal spirochetosis (HIS) is defined as a colonization of the apical membrane of the colonic mucosa and the appendix by spirochetes. It is a very rare finding, being more common in some populations (individuals living in villages and peri-urban environments in developing countries, recent immigrants from developing countries, men who have sex with other men and HIV positive patients), but the spirochete rarely is investigated as human enteric potential microorganism. It is a slow-growing microorganism and has specialized growth requirements, which is why it is not detectable in human fecal samples using routine diagnostic methods. However, it has been histologically identified attached to the colon and rectum in patients with conditions such as chronic diarrhea, rectal bleeding, and/or nonspecific abdominal discomfort. In this article we present the case of a patient with chronic diarrhea secondary to intestinal spirochetosis, highlighting the importance of considering this etiology in the differential diagnosis.