Background: Human intestinal spirochetosis is a condition defined by the presence of spirochetes attached to the colonic epithelium. and 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.
Learning Points: Uncommon causes of diarrhoea are a diagnostic challenge.Errors of clinical judgement can lead to invasive and potentially harmful procedures.An internist-based approach can prevent diagnostic mistakes and be in the patient's best interests.
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http://dx.doi.org/10.12890/2016_000501 | DOI Listing |
Clin Med Insights Case Rep
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Department of Radiology, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia.
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Department of Surgery, University Hospital "Tsaritsa Joanna - ISUL", Medical University, Str. "Byalo More" No 8, Sofia, Bulgaria.
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Hospital Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE.
Acute kidney injury (AKI) is typically classified as prerenal, renal, or postrenal in etiology, with postrenal often referring to obstructive causes. However, certain uncommon conditions, such as intraperitoneal urinary leaks, may not fit clearly into these categories. In patients with a recent history of pelvic procedure, a complication such as intraperitoneal urinary leak can mimic AKI due to urine reabsorption across the peritoneum.
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Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address:
Isolated ischemic necrosis of the cecum (INC) is an uncommon benign condition that occurs most often in elderly patients. The clinical presentation and radiographic findings often mimic acute appendicitis or malignancy. This study aimed to investigate the clinicopathologic features of mass-forming INC.
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February 2025
Radiology Unit, "Papardo" Hospital, Messina, ME 98158, Italy.
Multinodular steatosis represents a relatively uncommon manifestation of fatty liver disease (FLD). Co-morbidities such as metabolic syndrome or cirrhosis are often associated. Despite typical features of imaging (ultrasound, CT, and MRI), core biopsy sometimes remains the gold standard for diagnosis.
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