Yu Qing Qing, Tariq Amina, Unger Stephen W, Cabello-Inchausti Beria, Robinson Morton J
Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, Fla 33140, USA.
Arch Pathol Lab Med. 2004 Jul;128(7):801-3. doi: 10.5858/2004-128-801-PGAWKS.
We report a case of phlegmonous gastritis associated with Kaposi sarcoma in a 37-year-old, human immunodeficiency virus (HIV)-positive man who presented with an acute abdomen. Computed tomographic scan revealed free fluid in the abdominal cavity and a thickened gastric wall. A partial gastrectomy was performed. The resected portion of stomach had a hemorrhagic, necrotic thickened wall and showed extensive, acute suppurative inflammation, especially in the submucosa, with focal transmural involvement. Beneath an area of healing ulceration, a focus of Kaposi sarcoma was present. Group A beta-hemolytic streptococcus was grown from peritoneal fluid, and treatment with numerous antibiotics was initiated. After a difficult postoperative course that responded to 8 weeks of antibiotic therapy, the patient was medically stable and discharged from the hospital on antiretroviral therapy for HIV. Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the gastric wall. Kaposi sarcoma is one of the most common malignancies in HIV-positive patients, and gastric involvement is relatively common in those patients with systemic Kaposi sarcoma. To our knowledge, this is the first reported case of phlegmonous gastritis associated with Kaposi sarcoma, and it represents a rare survival following surgical and antibiotic therapy.
我们报告一例37岁的人类免疫缺陷病毒（HIV）阳性男性患者，其患有与卡波西肉瘤相关的蜂窝织炎性胃炎，并伴有急腹症。计算机断层扫描显示腹腔内有游离液体和胃壁增厚。进行了部分胃切除术。切除的胃部分有出血、坏死的增厚壁，显示广泛的急性化脓性炎症，尤其是在黏膜下层，有局灶性透壁累及。在愈合溃疡区域下方，存在卡波西肉瘤病灶。从腹腔积液中培养出A组β溶血性链球菌，并开始使用多种抗生素治疗。经过艰难的术后病程，在接受8周抗生素治疗后病情好转，患者病情稳定，出院后接受抗逆转录病毒治疗以治疗HIV。蜂窝织炎性胃炎是一种罕见且进展迅速的胃壁细菌感染。卡波西肉瘤是HIV阳性患者中最常见的恶性肿瘤之一，在系统性卡波西肉瘤患者中胃受累相对常见。据我们所知，这是首例报告的与卡波西肉瘤相关的蜂窝织炎性胃炎病例，并且它代表了手术和抗生素治疗后罕见的存活病例。
