The clinical aspects of Helicobacter heilmannii infection in children with dyspeptic symptoms.
Helicobacter heilmannii (H. heilmannii) infection is a relatively rare causative agent of gastroduodenal diseases in children. However, H. heilmannii frequently colonizes gastric mucosa of animals, mainly cats and dogs, from where it can be transmitted to humans. The aim of the study was to evaluate the incidence of H. heilmannii infection in children with dyspeptic symptoms treated in our clinic. A number of 13,124 esophagogastroduodenoscopies in children aged 4 to 18 years were conducted from 1992 to 2010. The indications for examination were: chronic abdominal pain, nausea, vomiting, heartburn, anaemia, disturbances of intestinal absorption and other. In 11,023 cases microbiologic studies and cultures toward Helicobacter infection were carried out and in 22 children H. heilmannii infection was confirmed. H. heilmannii infection was diagnosed based on morphologic examination in direct microscopy of biopsy specimens from gastric mucosa. In children with H. heilmannii infection clinical symptoms, contact with animals, endoscopic findings of the upper gastrointestinal tract and results of diagnostic tests for Helicobacter pylori infection were assessed. In our studies H. heilmannii infection was diagnosed in 22 children. The rate of H. heilmannii infection was 0.2% in examination of gastric mucosa specimens. No sex-dependent difference in the rates was observed. Most of the children lived in cities and 54.5% had contact with dogs and/or cats. Children complained of chronic epigastric pain, nausea, vomiting and heartburn. Endoscopic studies most often revealed nodular gastritis and gastric or duodenal ulcer in two children. In three children result of the endoscopic study was normal.


CONCLUSIONS
H. heilmannii infection in children is rare. However, it may be one of the causes of gastroduodenal diseases in children.
Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland. barbara@iwanczak.com
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Iwanczak
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Biernat
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Iwanczak
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Grabinska
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Matusiewicz
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Gosciniak
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004382:Duodenitis / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005756:Gastritis / Q000175:diagnosis / Q000382:microbiology; D006356:Heartburn; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology; D018247:Helicobacter heilmannii; D006801:Humans; D008297:Male; D009325:Nausea; D010437:Peptic Ulcer / Q000175:diagnosis / Q000382:microbiology; D014839:Vomiting