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• W2977679705 abstract "A 46-year-old homosexual male with a history of GERD, arthritis, and hypertension presented with recurrent intermittent attacks of diarrhea. He had recovered from a recent viral gastroenteritis. He is sexually active with multiple male partners, but denies receptive anal intercourse. Physical examination and laboratory data were unremarkable. Stool ova and parasites were positive for Blastocystis. Endoscopy showed H pylori-associated gastritis. Colonic mucosa appeared normal, with biopsies demonstrating spirchochetosis and Blastocystis hominis. He was treated with metronidazole and with a triple therapy regimen for H pylori. Intestinal spirochetosis (IS) was first described in 1967. The highest rates of colonization are in homosexual males, up to 20.6 - 62.5%. The syndrome varies from asymptomatic or mild disease to rare cases of invasive and fatal disease. Presenting symptoms include diarrhea (46%), abdominal pain (31%), rectal bleeding (31%), heme-positive stool (12%) or no symptoms (15%). Mucosal appearance is typically normal. Spirochetosis can be confirmed by the Warthin-Starry stain. Clinically significant IS is often reported to occur as co-infection with other microorganisms and is often more clinically aggressive in association with HIV disease. Blastocystis species are anaerobic parasites in the GI tract, with a prevalence of 30-50% in developing countries and 5-10% in developed countries. The clinical significance is debated and patients are often asymptomatic, and there is a higher incidence in immunocompromised patients. Cases of Blastocystis co-infection with spirochetes are uncommon. One report demonstrated co-infection in an immunocompetent patient with persistent diarrhea, with complete resolution after treatment with metronidazole. Antibiotics are used to eradicate IS in symptomatic patients, with variable efficacy. It is suggested that the degree of invasiveness of IS correlates with clinical signs and symptoms, and may predict which patients will respond to antibiotics. Treatment with metronidazole is typically successful, as in our patient. To our knowledge, there are no previous reports of co-infection with IS and H pylori. Given colonization in different locations of the GI tract, it is intriguing (yet challenging) to postulate a specific interaction.Figure 1Figure 2In summary, we present an interesting case of colonic co-infection by intestinal spirochetosis and Blastocystis (with H pylori gastritis) in an immunocompetent man." @default.
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• W2977679705 date "2016-10-01" @default.
• W2977679705 modified "2023-09-27" @default.
• W2977679705 title "A Case of a Co-infection with Blastocystis and Spirochetosis in an Immunocompetent Homosexual Male" @default.
• W2977679705 doi "https://doi.org/10.14309/00000434-201610001-02601" @default.
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