Lymphogranuloma Venereum Should be Ruled Out in Coloproctitis in Individuals Infected with HIV

The differential diagnosis in the case recently published in the journal1 deserves some consideration. Intestinal spirochetosis2,3 is a frequent animal infection occasionally seen in humans, with higher rates of infection in homosexual men and human immunodeficiency virus (HIV)-positive individuals. The condition may be asymptomatic, being evidenced only in colonoscopic biopsy specimens, or may cause chronic diarrhea, pain, flatulence, and blood in stools, although the presentation as severe colitis with perirectal lymphadenopathy with magnetic resonance imaging is rare.