Cases reported "Gastritis"

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1/103. Molecular relationships of helicobacter pylori strains in a family with gastroduodenal disease.

    OBJECTIVE: Few studies have examined the genetic relationships of helicobacter pylori strains affecting family members. Our aim was to do so. methods: We characterized H. pylori isolates obtained from members of a single family presenting with various gastroduodenal diseases to examine H. pylori bacterial genetic similarity. Endoscopic evaluation with gastric mapping was performed on each individual to establish clinical and histological disease. Genomic DNA extracted from each H. pylori isolate was used to generate DNA fingerprints for each strain by REP-PCR. vacA genotypes and cagA presence were established by PCR. RESULTS: gastrointestinal diseases among the five members of this family included gastric adenocarcinoma in a 52-yr-old man (index patient), gastric MALT-lymphoma in the 73-yr-old mother; intestinal metaplasia (IV) and atrophic gastritis in the 48-yr-old brother; intestinal metaplasia (I-III) in the 47-yr-old brother, and a duodenal ulcer scar in the 42-yr-old sister. REP-PCR DNA fingerprints of H. pylori isolates from the index patient, his mother, and both of his brothers were identical or highly similar. By contrast, the H. pylori DNA fingerprint from the sister was markedly different from the H. pylori DNA fingerprints from the other family members. All isolates had the genotype cagA-positive and vacA slb/ml mosaic genotype. CONCLUSIONS: The DNA fingerprints of H. pylori strains obtained from members of this family with malignancy or premalignant histological disease were identical or highly similar and markedly different from the H. pylori DNA fingerprint from the sibling with duodenal ulcer disease. All H. pylori isolates within the family possessed genetic markers of enhanced virulence (presence of the cagA gene and vacA sl/ml mosaicism). In addition to host genetics and environmental factors, these findings suggest that infection with genetically similar H. pylori strains is a significant factor in determining the clinical outcome of an infection with H. pylori.
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ranking = 1
keywords = infection
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2/103. CD4/CD8 double-positive adult T cell leukemia with preceding cytomegaloviral gastroenterocolitis.

    We present a rare case of adult T cell leukemia (ATL) in which leukemic T cells simultaneously expressed CD4 and CD8 surface antigens and refractory cytomegalovirus (CMV)-induced gastroenterocolitis preceded its clinical onset. A 40-year-old male was admitted to our hospital with abdominal pain and bloody stool. biopsy specimens of the gastric and rectal mucosa indicated CMV-induced gastroenterocolitis. The patient also proved to be seropositive for human T lymphotropic virus type I (HTLV-I). While being administered gancyclovir for CMV infection, he presented hepatomegaly and systemic lymphadenopathy. Monoclonal expansion of lymphoid cells integrated with HTLV-I genome was observed. He underwent a LSG15 regimen and hepatomegaly and lymphadenopathy improved markedly. Gastroenterocolitis also improved, but the symptoms did not disappear completely. CMV-induced diseases are prevalent among immunosuppressed patients. Although there was no evidence that this patient had ATL on admission, it is likely that he was severely immunodeficient. CMV can easily infect damaged mucosa. ATL cells often infiltrate gastrointestinal mucosa and may have triggered CMV gastroenterocolitis in this case.
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ranking = 0.5
keywords = infection
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3/103. A case of acute phlegmonous gastritis successfully treated with antibiotics.

    Acute phlegmonous gastritis is a rare disorder in which bacterial infection occurs in the gastric wall. gastrectomy involving the affected area has been thought to be an effective form of treatment. The authors report a case of a 32-year-old woman who had severe upper abdominal pain without signs of peritoneal irritation. endoscopy showed edematous and reddened gastric mucosa with a mass lesion in the gastric antrum. Endoscopic ultrasonography showed thickening of the antral wall and a low-echoic mass in the gastric antrum, thought to represent a fluid collection. White pus was aspirated from the mass. Localized type of acute phlegmonous gastritis with a gastric abscess was diagnosed. culture of the pus showed streptococcus pneumoniae. Through early diagnosis without laparotomy, the patient's gastritis was successfully treated with antibiotics alone.
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ranking = 3.2808538863034
keywords = bacterial infection, infection
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4/103. Evolution of acute cytomegalovirus gastritis to chronic gastrointestinal dysmotility in a nonimmunocompromised adult.

    A 30-year-old nonimmunocompromised woman developed chronic gastrointestinal dysmotility as a consequence of acute cytomegalovirus infection. The acute nature of the infection was documented by high immunoglobulin m antibody titer to cytomegalovirus (CMV); the chronicity of the infection was shown by persistence of CMV in biopsy specimens of her gastrointestinal tract over a 21/2-year period. Gastrointestinal dysmotility was confirmed by delayed emptying on gastric nuclear scintigraphy, by retrograde propagation of migrating myoelectric complexes on small intestinal manometry, and by presence of tachygastria on cutaneous electrogastrography. The patient's nausea, vomiting, abdominal pain, and early satiety resolved after a short course of treatment with leuprolide acetate but returned after medication was discontinued. Her symptoms persisted despite clearance of CMV from the gastrointestinal tract after a course of treatment with ganciclovir. These observations show that acute CMV infection can cause gastrointestinal dysmotility in nonimmunocompromised individuals and that the disturbance in gastrointestinal motor function may persist for years after viral infection of the gastrointestinal tract has been eradicated.
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ranking = 2.5
keywords = infection
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5/103. Characteristics and prevalence of helicobacter heilmannii infection in children undergoing upper gastrointestinal endoscopy.

    BACKGROUND: helicobacter heilmannii, described in 1983 as a new cause of chronic gastritis, has been reported rarely in children. The purpose of this study was to determine the clinical characteristics and the prevalence of H. heilmannii infection, in comparison with helicobacter pylori infection in children undergoing upper digestive endoscopy. methods: Diagnosis of H. heilmannii was based on its morphologic characteristics in gastric biopsy specimens (two from the antrum, one from the fundus), whereas H. pylori infection was defined by histology and/or culture (one specimen from the antrum, one from the fundus). Respective prevalences of H. heilmannii and H. pylori were calculated in 518 patients studied prospectively who underwent systematic biopsies. RESULTS: The prevalence of H. pylori was 8.9% (46/518) and increased with age (from 2% before 3 years of age to 18% after 10 years). On the contrary, the prevalence of H. heilmannii infection was low, 0.4% (2/518), and no different from that published in adults. After completion of the study period, a third H. heilmannii-infected child was diagnosed. Characteristics of H. heilmannii infection could be studied in these three children 5, 9, and 14 years old. Two of three had abdominal pain and one had dysphagia. Nodular gastritis was observed at endoscopy in two children. H. heilmannii chronic active gastritis (n = 3) was localized in the antrum, associated with an interstitial infiltrate, and could not be distinguished from H. pylori gastritis (n = 46). CONCLUSION: Clinical characteristics, endoscopic features and gastric histopathology did not allow H. heilmannii to be distinguished from H. pylori gastritis in our pediatric population. H. heilmannii infection should be considered and carefully looked for during histologic examination of gastric specimens in cases of H. pylori-negative gastritis.
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ranking = 5
keywords = infection
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6/103. Phlegmonous gastritis following coronary bypass surgery.

    Phlegmonous gastritis is a rare, rapidly progressive and potentially fatal gastric bacterial infection. A case of phlegmonous gastritis following a coronary bypass surgery is described. This condition was not diagnosed premortem due to the nonspecific nature of the gastrointestinal symptoms. Upper gastrointestinal endoscopy may be of value in establishing the diagnosis in emergencies with culture of gastric aspirate and biopsy.
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ranking = 3.2808538863034
keywords = bacterial infection, infection
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7/103. Pseudomembranous gastritis: a novel complication of aspergillus infection in a patient with a bone marrow transplant and graft versus host disease.

    A 36-year-old Hispanic man who had undergone allogeneic bone marrow transplantation, complicated by graft versus host disease, was admitted with acute gastrointestinal symptoms, including severe diarrhea and diffuse abdominal pain. He also had a persistent cough with sputum production. blood cultures yielded escherichia coli, and sputum cultures grew Apergillus species. The patient was treated with antifungal agents and broad-spectrum antibiotics. Despite aggressive medical therapy, the patient died 10 days after admission. Postmortem examination disclosed severe, bilateral confluent bronchopneumonia, with numerous septated branching hyphae consistent with aspergillus species fungal organisms that involved the pulmonary parenchyma and tracheobronchial tree. Although the small and large bowels were only mildly congested, the entire gastric mucosa was covered with a 1.5-cm-thick pseudomembrane that contained numerous aspergillus organisms. Our report represents the first description, to our knowledge, of a diffuse inflammatory pseudomembrane in the stomach, a complication that to date has only been associated with small and large bowel involvement.
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ranking = 2
keywords = infection
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8/103. Direct evidence by dna fingerprinting that endoscopic cross-infection of helicobacter pylori is a cause of postendoscopic acute gastritis.

    The dna fingerprinting of helicobacter pylori strains in two cases of acute gastritis that occurred after endoscopy was examined. H. pylori was isolated from the stomachs of two patients with acute gastritis and from the stomachs of the patients in whom the same gastrofiberscope had previously been used. The genomic DNA digested with HaeIII was subjected to pulsed-field gel electrophoresis. The corresponding paired electrophoretic patterns were completely identical. These findings provide direct evidence that postendoscopic acute gastritis can be caused by cross-infection with H. pylori via endoscopy.
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ranking = 2.5
keywords = infection
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9/103. H pylori infection. review of the guideline for diagnosis and treatment.

    helicobacter pylori infection is prevalent among persons over age 60, is strongly associated with peptic and duodenal ulcer, and is caused by a microbe classified as a carcinogen. These factors combine to make the primary care physician key to proper diagnosis and treatment of H pylori infection. In 1998, the American College of gastroenterology published an evidence-based guideline for the management of this infection. The guideline produced several fundamental recommendations that help clarify the management process: asymptomatic persons should not undergo testing, but testing should be performed on certain persons, testing should only be done if the intention is to treat; the choice of test is governed by the need for endoscopy; and several triple-therapy regimens are effective for eradication.
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ranking = 3.5
keywords = infection
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10/103. Severe acute gastritis associated with helicobacter pylori infection.

    We describe the case of a young female referred to our unit because of acute upper abdominal symptoms. Upper gastrointestinal endoscopy showed a gastric picture resembling lymphoma or acute non-steroidal anti-inflammatory drug gastropathy (deep, large and irregular ulcers), but the clinical history and the histological examination of gastric biopsies were consistent only with acute gastritis helicobacter pylori-correlated. The patient was treated with omeprazole and antibiotics with complete recovery. As the patient's cat had suffered from an acute gastrointestinal distress two weeks earlier, a case of zoonosis was hypothesized and an upper gastrointestinal endoscopy was performed also on the cat. Unfortunately, we were not able to detect helicobacter pylori in the cat gastric mucosa, but only urease-producing spiral microorganisms. Possible sources of infection and pathogenetic mechanisms of the severe gastritis are discussed.
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ranking = 2.5
keywords = infection
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