{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:31:25Z","timestamp":1769117485343,"version":"3.49.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\u2018Soluble\u2019 total colon necrosis is a rare condition with an unclear etiology and few reports on treatment modalities. This case report describes severe intestinal necrosis in an HIV-infected patient, detailing clinical manifestations, diagnostic process, treatment regimen, and outcomes, thereby providing a reference for similar cases in the future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description<\/jats:title>\n                    <jats:p>The patient is a 41-year-old man diagnosed with HIV 6\u202fyears ago, receiving long-term therapy with tenofovir, lamivudine, and efavirenz. He has no history of smoking, alcohol consumption, inflammatory bowel disease, or intestinal tuberculosis, but has had multiple sexual partners. He was admitted with 3\u202fh of abdominal pain; a blood pressure of 108\/76\u202fmmHg; a heart rate of 148\u202fbpm, and physical findings of generalized abdominal tenderness, rebound tenderness, muscle rigidity, and diminished bowel sounds. Laboratory results showed elevated procalcitonin (5.15\u202fng\/mL), white blood cells (9.2\u202f\u00d7\u202f10^9\/L), and C-reactive protein (232.10\u202fmg\/L). Abdominal CT revealed thickened walls in the ileocecal region, colon, and rectum, with small bowel dilation, gas, and fluid accumulation, indicating hollow organ perforation and diffuse peritonitis. Emergency laparotomy revealed extensive necrosis of the colon and rectum, with perforation at the hepatic flexure of the colon. A total colectomy, rectal resection, and ileostomy were performed. Postoperative pathology revealed acute and chronic suppurative inflammation with necrosis and perforation. Postoperative sepsis developed, and further examination revealed the presence of syphilis antibodies and liver function impairment. Following treatment with anti-infective, anti-inflammatory, liver-protective, and nutritional support therapies, the patient\u2019s condition improved. On the 9th postoperative day, the patient was transferred to a community hospital for further treatment and was discharged on the 23rd postoperative day.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates the rare occurrence of extensive necrosis and perforation of the colon in an HIV-infected patient with co-occurring syphilis. Although the precise role of syphilis in the development of gastrointestinal complications remains uncertain, this case highlights the need for heightened clinical awareness of co-infections in immunocompromised patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1687800","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:14:46Z","timestamp":1769058886000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Extensive colonic necrosis and perforation in an HIV patient with syphilis complicated by sepsis"],"prefix":"10.3389","volume":"12","author":[{"given":"Shouxin","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Suining Central Hospital","place":["Suining, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sijia","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of General Practice, Suining Central Hospital","place":["Suining, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Suining Central Hospital","place":["Suining, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1186\/s12879-023-08164-5","article-title":"The impact of HIV infection on clinical presentation and mortality among persons with hepatocellular carcinoma in Kampala, Uganda","volume":"23","author":"Nsibirwa","year":"2023","journal-title":"BMC Infect 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as a cause of intestinal obstruction in immunocompromised patients: case report and literature review","volume":"16","author":"Grajales-Urrego","year":"2024","journal-title":"Gut Pathog"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1186\/s12876-020-01381-1","article-title":"Colon perforation due to cytomegalovirus infection in a patient with idiopathic hypereosinophilic syndrome: a case report","volume":"20","author":"Luo","year":"2020","journal-title":"BMC Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e22455","DOI":"10.7759\/cureus.22455","article-title":"Simultaneous occurrence of cytomegalovirus colitis and retinitis as the initial presentation of human immunodeficiency virus infection in a patient with zero CD4 count","volume":"14","author":"Munshi","year":"2022","journal-title":"Cureus"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"276","DOI":"10.2143\/acb.67.4.2062672","article-title":"Fever in HIV-infected 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