An Uncommon Cause of Diarrhoea and the Importance of an Internist Approach

Monteiro, Filipa Brás and Ferreira, Sofia Cristóvão and Mendes, Rita (2017) An Uncommon Cause of Diarrhoea and the Importance of an Internist Approach. European Journal of Case Reports in Internal Medicine, 4 (2). ISSN 2284-2594


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Background: Human intestinal spirochetosis is a condition defined by the presence of spirochetes attached to the colonic epithelium. Brachyspira aalborgi and Brachyspira pilosicoli may cause the disease in humans. Case report: We describe the case of a 58-year-old patient who presented with epigastric abdominal pain and diarrhoea. He was thought to be having a myocardial infarction and underwent an angiogram with subsequent stenting of the circumflex coronary artery. However, the pain and diarrhoea were still present after the procedure and the patient now had sepsis. An exploratory laparotomy was inconclusive. The patient improved on intravenous antibiotics and was discharged, but returned to the emergency department 2 days later with the same complaints. He was then admitted to an internal medicine ward where the diagnosis of intestinal spirochetosis was made. The patient was started on metronidazol and completed a 10-day antibiotic course with full recovery of his symptoms. Conclusion: This case highlights the importance of an internist-based approach that could have prevented two invasive procedures and the accompanying risks.

Item Type: Article
Uncontrolled Keywords: Diarrhoea; Brachyspira aalborg; type 2 myocardial infarction; peritonitis
Subjects: 600 Tecnologia - Scienze applicate
600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici)
Depositing User: Michela Donatelli
Date Deposited: 08 May 2017 13:11
Last Modified: 08 May 2017 13:11

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