Pediatric Gastroenterology and Nutrition Service, National Institute of Pediatrics, Mexico City, Mexico.
Laboratory of Experimental Bacteriology, National Institute of Pediatrics, Mexico City, Mexico.
BMC Pediatr. 2023 Jul 15;23(1):364. doi: 10.1186/s12887-023-04142-7.
Gastric non-Helicobacter pylori helicobacters (NHPH) naturally colonize the stomach of animals. In humans, infection with these bacteria is associated with chronic active gastritis, peptic ulceration and MALT-lymphoma. H. bizzozeronii belongs to these NHPH and its prevalence in children is unknown.
This case report describes for the first time a NHPH infection in a 20-month-old girl with severe gastric disorders in Mexico. The patient suffered from melena, epigastric pain, and bloating. Gastroscopy showed presence of a Hiatus Hill grade I, a hemorrhagic gastropathy in the fundus and gastric body, and a Forrest class III ulcer in the fundus. Histopathologic examination revealed a chronic active gastritis with presence of long, spiral-shaped bacilli in the glandular lumen. Biopsies from antrum, body and incisure were negative for presence of H. pylori by culture and PCR, while all biopsies were positive for presence of H. bizzozeronii by PCR. Most likely, infection occurred through intense contact with the family dog. The patient received a triple therapy consisting of a proton pump inhibitor, clarithromycin, and amoxicillin for 14 days, completed with sucralfate for 6 weeks, resulting in the disappearance of her complaints.
The eradication could not be confirmed, although it was suggested by clear improvement of symptoms. This case report further emphasizes the zoonotic importance of NHPH. It can be advised to routinely check for presence of both H. pylori and NHPH in human patients with gastric complains.
胃非幽门螺杆菌螺旋菌(NHPH)自然定植于动物的胃中。在人类中,这些细菌的感染与慢性活动性胃炎、消化性溃疡和 MALT 淋巴瘤有关。H. bizzozeronii 属于这些 NHPH,其在儿童中的流行情况尚不清楚。
本病例报告首次描述了一例 20 个月大的墨西哥女孩患有严重胃部疾病的 NHPH 感染。患者出现黑便、上腹痛和腹胀。胃镜检查显示存在 I 级食管裂孔疝、胃底和胃体出血性胃炎以及胃底 III 级 Forrest 溃疡。组织病理学检查显示慢性活动性胃炎,腺腔内存在长而螺旋状的杆菌。胃窦、体和切迹的活检均通过培养和 PCR 检测为 H. pylori 阴性,而所有活检均通过 PCR 检测为 H. bizzozeronii 阳性。很可能是通过与家庭犬的密切接触而感染。患者接受了三联疗法,包括质子泵抑制剂、克拉霉素和阿莫西林治疗 14 天,并用硫糖铝治疗 6 周,症状明显改善。
尽管症状明显改善,但无法确认根除情况。本病例报告进一步强调了 NHPH 的人畜共患重要性。建议对有胃部不适的人类患者常规检查 H. pylori 和 NHPH 的存在情况。