Infecciones entéricas: tratamiento, causas, síntomas, diagnóstico y prevención

Las personas que practican sexo anal o relaciones sexuales en las que realizan contacto oral-fecal, pueden presentar proctocolitis y enteritis (capítulos 91 y 94). Entre los posibles agentes patógenos causales destacan Campylobacter, Shigella, Entamoeba histolytica, C. trachomatis (serotipos del LGV) y Giardia lamblia. Así mismo, los pacientes infectados por el VIH pueden presentar infecciones a partir de agentes que normalmente no se transmiten por vía sexual, como citomegalovirus, Mycobacterium avium-intracellular, Salmonella, Cryptosporidium, Microsporidium e Isospora.9


Los síntomas de la proctocolitis son dolor anorrectal, tenesmo, secreciones rectales, diarrea y calambres abdominales. Los pacientes con enteritis presentan calambres abdominales y diarrea, pero sin signos de proctocolitis.


Se realiza mediante las pruebas y métodos diagnósticos apropiados, como anoscopia, sigmoidoscopia, examen de las heces y coprocultivo. En ocasiones resulta necesario obtener múltiples muestras de heces para realizar el diagnóstico de infestación por Giardia; así mismo, para el diagnóstico de la criptosporidiosis y la microsporidiosis son necesarias preparaciones especiales.9


El tratamiento depende del diagnóstico específico.


El seguimiento depende del diagnóstico. Hay que informar a los pacientes acerca del mecanismo de transmisión de su infección. Hay que visitar a los compañeros sexuales, valorarlos y tratar si está indicado.


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