Internal Medicine, Tottori Municipal Hospital, 1-1 Matoba, Tottori, 6808501, Japan.
Clin J Gastroenterol. 2021 Apr;14(2):500-505. doi: 10.1007/s12328-021-01345-2. Epub 2021 Feb 4.
We report a case of phlegmonous gastritis that followed an episode of acute pharyngitis. A 21-year-old man visited our emergency room because of intense epigastric pain. Fourteen days before the visit, he had symptoms of a sore throat and high fever. He was diagnosed with acute pharyngitis and treated with antibiotics. Although the symptoms of acute pharyngitis were relieved, epigastric pain began 5 days before the emergency visit. Computed tomography showed diffuse gastric wall thickening, and emergent esophagogastroduodenoscopy revealed diffusely spreading hyperemic mucosa with multiple erosions. He was admitted with a diagnosis of acute phlegmonous gastritis and was treated with antibiotics. The antibiotic treatment was effective and resulted in resolution of his clinical symptoms and normalized C-reactive protein concentrations. On hospital day 29, he was discharged. However, he was re-admitted because of recurrence of phlegmonous gastritis 5 days after discharge and 15 days after finishing the antibiotics. Cultures of gastric biopsies and juice were both positive for Streptococcus constellatus/milleri. Antibiotic treatment was effective, and he recovered without recurrence. A possible association between upper respiratory infections and subsequent phlegmonous gastritis has been reported, and this case supports causality. However, further studies are needed to evaluate causality and pathogenesis.
我们报告了一例继发于急性咽炎的蜂窝织胃炎。一名 21 岁男性因剧烈上腹痛就诊于我院急诊。在就诊前 14 天，他出现咽痛和高热症状。他被诊断为急性咽炎，并接受了抗生素治疗。虽然急性咽炎的症状有所缓解，但在急诊就诊前 5 天开始出现上腹痛。CT 显示弥漫性胃壁增厚，急诊胃镜检查显示弥漫性扩张的充血性黏膜伴有多个糜烂。他被诊断为急性蜂窝织胃炎并接受了抗生素治疗。抗生素治疗有效，临床症状缓解，C 反应蛋白浓度恢复正常。在住院第 29 天，他出院。然而，他在出院后 5 天、抗生素治疗结束后 15 天因再次发生蜂窝织胃炎而再次入院。胃活检和胃液培养均为星座链球菌/米勒链球菌阳性。抗生素治疗有效，他痊愈且无复发。有报道称上呼吸道感染与随后的蜂窝织胃炎之间存在关联，本病例支持因果关系。然而，还需要进一步研究来评估因果关系和发病机制。
