title: A case of acute gastric mucosal lesions associated with Helicobacter heilmannii infection.
abstract: A 69-year-old-woman presented with acute epigastric pain, nausea, vomiting and heartburn. Endoscopy disclosed acute gastric mucosal lesions including mucosal edema, erosions, and ulcers with blood crusts in the antrum. Touch cytology and histological assessment obtained from the affected mucosa revealed acute neutrophilic gastritis and single longer and more coiled organisms than Helicobacter pylori, suggesting Helicobacter heilmannii. Electron micropragh confirmed the characteristic morphology. Despite a positive rapid urease test, H. pylori was not isolated by culture or detected by histology and Gram smears. Based on these findings, a diagnosis of acute gastric mucosal lesions associated with H. heilmannii infection was established. This was successfully treated with a 2-week triple therapy consisting of lansoprazole, clarithromycin and metronidazole with persistent endoscopic and histological remission. This is a rare case of H. heilmannii-associated acute gastric mucosal lesions, diagnosed by morphology using touch cytology and histology. The patient might benefit from antimicrobial treatment employing the regimen effective for H. pylori.
authors.affiliation: Internal Medicine, Omura Municipal Hospital, 132-1 Kogashima, Omura, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Saburo
authors.initials: S
authors.lastname: Shikuwa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Osabe
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Omagari
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mizuta
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Murase
authors.forename: Ikuo
authors.initials: I
authors.lastname: Murata
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000368:Aged; D001431:Bacteriological Techniques; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology* / Q000473:pathology*; D005756:Gastritis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D018247:Helicobacter heilmannii / Q000302:isolation & purification*; D006801:Humans