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oai:repisalud.isciii.es:20.500.12105/162682024-11-29T09:42:19Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19609col_20.500.12105_16977

00925njm 22002777a 4500 dc Pérez-Tanoira, Ramón author Del Palacio Tamarit, Marta author Vicente Montaña, Ana María author Carmena, David author Köster, Pamela Carolina author Górgolas, Miguel author Fortes Alen, José R author Cabello-Úbeda, Alfonso author Prieto-Pérez, Laura author 2023-04-26 Human intestinal spirochetosis (HIS) can cause gastrointestinal symptoms, although asymptomatic infections have been described. Individuals from low-income countries, people living with HIV, and men who have sex with men (MSM) show increased risk. A retrospective review of all patients diagnosed with HIS (n = 165) between January 2013 and October 2020 at a tertiary hospital in Madrid, Spain, was performed to assess risk factors for symptomatic HIS, symptoms, and response to treatment. Most patients were male (n = 156; 94.5%), 86.7% were MSM, and 23.5% practiced chemsex, of whom most were symptomatic (p = 0.039). Most patients (78.4%) reported unprotected oral-anal intercourse. A total of 124 (81.1%) were symptomatic; diarrhea was the most common complaint (68.3%). Multivariable regression showed increased odds of symptoms associated with age under 41 (odds ratio 5.44, 95% CI 1.87-15.88; p = 0.002). Colonoscopy was normal in 153 (92.7%). Furthermore, 66.7% presented previous or concomitant sexually transmitted diseases (STDs). Among the patients, 102 underwent testing for other gastrointestinal pathogens, with positive results in 20 (19.6%). All symptomatic patients without concomitant gastrointestinal infection presenting improvement on follow-up (42 of 53) had received either metronidazole or doxycycline (p = 0.049). HIS should be considered as a cause of chronic diarrhea in MSM with high-risk sexual behavior after other causes have been ruled out; treatment with metronidazole is recommended. Coinfection with other STDs is common. Trop Med Infect Dis. 2023 Apr 26;8(5):250. 10.3390/tropicalmed8050250 2414-6366 Tropical medicine and infectious disease 37235298 http://hdl.handle.net/20.500.12105/16268 Intestinal spirochetosis Diarrhea Brachyspira MSM Chemsex HIV infection Histopathology Metronidazole Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals