Review ArticlesIntestinal Spirochetes in Cancer Patients Our Experience and Review of the LiteratureCheema, Asima MD∗; Jejelowo, Oluwafisayo BS†; Syed, Misbahuddin MD‡; Ramsakal, Asha DO§; Greene, John N. MD∥Author Information From the ∗Moffitt Cancer Center and Research Institute †Morsani College of Medicine, University of South Florida Departments of ‡Internal and Hospital Medicine §Medicine ∥Moffitt Cancer Center and Research Institute, Tampa, FL. Correspondence to: John N. Greene, MD, Moffitt Cancer Center and Research Institute 12902 Magnolia Dr, FOB-3, Tampa, FL 33612. E-mail: [email protected]. The authors have no funding or conflicts of interest to disclose. Because of the nature of the study and limited number of retrospective patient clinical observations, this review was deemed exempt from the institutional review board committee review process. Infectious Diseases in Clinical Practice: May 2020 - Volume 28 - Issue 3 - p 134-137 doi: 10.1097/IPC.0000000000000846 Buy Metrics AbstractIn Brief The clinical significance of human intestinal spirochetosis is a debated topic, with possible links to various gastrointestinal symptoms such as diarrhea and hematochezia. The most commonly associated organisms in humans involve Brachyspira aalborgi and Brachyspira pilosicoli. However, the presence of spirochetes within the colorectal epithelium does not always suggest pathogenicity, and treatment does not always lead to symptom improvement. Men who have sex with men and patients infected with the HIV have been considered at higher risk of colonization and subsequently becoming symptomatic, possibly related to an underlying immunosuppressed state. We present a series of 3 case reports of human intestinal spirochetosis in immunocompromised cancer patients at the Moffitt Cancer Center and Research Institute. The aim of this study is to increase awareness of this entity in immunocompromised cancer patients and non–HIV-positive immunosuppressed patients, particularly when presenting with gastrointestinal symptoms of unclear etiology. Human intestinal spirochetosis (HIS), associated in humans with Brachyspira aalborgi and Brachyspira pilosicoli, has typically been associated in those infected with the human immunodefi ciency virus. However, the aim of this study is to describe immunodefi cient cancer patients identifi ed with HIS and discuss the debatable effect of treatment with clinical resolution of gastrointestinal symptoms. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.