Shin Jung A, Lee Young Bae, Yoon In Cheol, Jeong Hyeon Ju, Kwon Taejung, Lee Hong Sub
aDepartment of Internal Medicine, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea.
bDepartment of Pathology, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea.
Case Rep Gastroenterol. 2017 Mar 21;11(1):162-167. doi: 10.1159/000456607. eCollection 2017 Jan-Apr.
Bacterial esophagitis is a very rare condition usually occurring in patients with immunosuppression. To our best knowledge, bacterial esophagitis without underlying immunosuppressive disease has not been reported. We report an immunocompetent patient with bacterial esophagitis caused by B-hemolytic which resulted in an esophageal stricture. A 68-year-old female was admitted for odynophagia which had developed several days before. Upper endoscopy revealed extensive ulceration covered by whitish exudates with submucosal edema at the proximal esophagus. She was treated with steroids and empirical broad-spectrum antibiotics. Within 14 days the symptoms improved. Since growth of B-hemolytic was detected in nasal smear culture, bacterial esophagitis was suspected. Gram staining was carried out on the already obtained tissue that had been fixed with formalin. There was heavy infiltration with gram-positive cocci morphologically consistent with . Since the bacterial colony was demonstrated histologically, the diagnosis of bacterial esophagitis caused by B-hemolytic was confirmed. In addition, complete resolution of the inflammation following antibiotics therapy was further evidence of the bacterial cause of the esophagitis.
细菌性食管炎是一种非常罕见的疾病，通常发生在免疫抑制患者中。据我们所知，尚未有关于无潜在免疫抑制疾病的细菌性食管炎的报道。我们报告一例免疫功能正常的患者，其细菌性食管炎由B型溶血性链球菌引起，并导致食管狭窄。一名68岁女性因数天前出现的吞咽疼痛入院。上消化道内镜检查显示食管近端有广泛溃疡，表面覆盖白色渗出物，伴有黏膜下水肿。她接受了类固醇和经验性广谱抗生素治疗。14天内症状有所改善。由于在鼻涂片培养中检测到B型溶血性链球菌生长，怀疑为细菌性食管炎。对已用福尔马林固定的组织进行革兰氏染色。有大量革兰氏阳性球菌浸润，形态与B型溶血性链球菌一致。由于组织学上证实有细菌菌落，确诊为由B型溶血性链球菌引起的细菌性食管炎。此外，抗生素治疗后炎症完全消退进一步证明了食管炎的细菌病因。
