A 42-year-old man has appeared in court in Louisiana charged with nine counts of first degree murder.

Ronald Dominique pleaded not guilty to the charges, which relate to the rape and murder of nine men in Terrebonne County between 2002 and 2005.

The accused was arrested by police at a homeless shelter last month.

During his interrogation he allegedly confessed to the murders of 23 men.

Many of his victims were transients and some of them were gay.

They offered money by Dominique for sex. He would also claim to be married and offer his non-existent wife for sex in order to lure heterosexual men.

Bodies linked to Dominique have been found in six Louisiana parishes, and he has been implicated in the murder of two men in New Orleans.

In court, the some family members of the dead men were present.

The defendant was wheeled into court, and is reported to suffer from a heart condition.

One of those in court to observe proceedings was the mother of one of the murder and rape victims, Angela Smith.

“I wish I could have talked to him. I want to ask him ‘Before you killed my child, what were his last words?’” Smith said, according to DallasVoice.com

“I couldn’t even see him. That’s how bad a shape he was in when they sent him back to me,” she said of her son Wayne.