RESUMO
We present the case of an HIV-positive patient admitted because of costal pain secondary to neoplasia. During investigations, a colonoscopy showed non-specific ulcerations. Histological examination resulted in a diagnosis of intestinal spirochetosis. This infection can be asymptomatic or cause non-specific symptoms such as diarrhoea or abdominal pain. Intestinal spirochetosis should be included in the differential diagnosis of colon lesions in patients with HIV infection. LEARNING POINTS: Intestinal spirochetosis is associated with chronic diarrhoea and often with normal colonoscopy.This infection should be included in the differential diagnosis of HIV patients with digestive symptomatology in the absence of other more frequent causes.
RESUMO
BACKGROUND: Emerging fungi infections, although being not the most frequent, are a cause of major morbidity and mortality in recipients of solid organ transplants. The infections caused by the fungi Scedosporium apiospermum are a paradigmatic example of these. CASE REPORT: We present the clinical case of a 55 year-old female kidney transplant recipient that got infected with S. apiospermum through the skin. Intensive antifungal therapy was started, especially considering that the patient had an arteriovenous fistula at the site of infection. The fungus could have kept in the fistula, and a subsequent reinfection took place. The patient required both medical and surgical treatment (removal of the prosthetic material), that led to a complete recovery. CONCLUSIONS: S. apiospermum infections carry a high risk of complications, and are a frequent cause of morbidity and mortality in immunosuppressed/transplant patients. Therefore, the adequate knowledge of this type of mycosis, as well as the making of an adequate differential diagnosis, become fundamental for the prevention of the complications arising from them.