MSM risk behaviors linked to diarrheaIncreased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals.
Use of antibiotics for treatment
We explored the connections between human intestinal spirochetosis (HIS) and its symptoms, particularly diarrhea, in a group of individuals diagnosed at a tertiary hospital in Madrid. Our focus was on understanding how risky behaviors, especially among men who have sex with men (MSM), impact the prevalence of HIS and associated gastrointestinal issues.
In our review of 165 patients diagnosed with HIS, we found that most were male, with a significant majority identifying as MSM. Notably, a substantial portion of these individuals reported engaging in chemsex and unprotected oral-anal intercourse. Overall, 81.1% of patients were symptomatic, and diarrhea, notably the most common complaint (68.3%), raised concerns about the link between HIS and severe gastrointestinal distress.
Our analysis revealed that younger patients, particularly those under 41, had a higher likelihood of experiencing symptoms. Despite this, a high percentage (92.7%) had normal colonoscopy results. Interestingly, many patients also had previous or concurrent sexually transmitted diseases, which can complicate the diagnosis and treatment.
We observed that for symptomatic patients who did not have other gastrointestinal infections, treatment with metronidazole or doxycycline led to improvements. This highlights the importance of considering HIS as a potential cause of chronic diarrhea in MSM, especially after ruling out other conditions. Hence, we recommend this treatment approach for those exhibiting symptoms linked to HIS.
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Human intestinal spirochetosis linked to MSMHuman intestinal spirochetosis, a sexually transmissible infection? Review of six cases from two sexually transmitted infection centres in Barcelona.
Examines MSM and diarrhea connection
We explored the intriguing link between human intestinal spirochetosis (HIS) and chronic diarrhea, focusing on a group of six men who have sex with men (MSM). This condition significantly affects young MSM, particularly those living with HIV. During our review, we found that five of these six patients experienced diarrhea, which was often linked to their sexual practices, including condomless anal intercourse and oro-anal sex.
Importantly, all diagnoses were confirmed through colon biopsies using a special staining technique. Treatment for these patients involved metronidazole for five of them and benzathine penicillin G for one. Remarkably, all patients responded successfully to their treatments.
Overall, our study suggests that HIS should be considered in MSM presenting with ongoing diarrhea, particularly when paired with risky sexual behaviors or concurrent sexually transmitted infections (STIs). This connection indicates that HIS might even be sexually transmitted, underscoring the importance of awareness in this community.
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