Background:Sarcina ventriculi is a gram-positive, nonmotile, chemoorganotrophic anaerobic organism, which is rare in humans. It has been reported to be associated with conditions that result in delayed gastric emptying including gastric outlet obstruction and gastroparesis. There is also an association with emphysematous gastritis and gastric perforation.
Case Report: We report a case of a 34-year-old man with 2-year history of abdominal pain and 1-month history of frequent vomiting, with associated bloating, abdominal distention, belching, and farting. He was evaluated for gastric outlet obstruction secondary to a possible gastric tumor. Upper gastrointestinal (GI) endoscopy revealed food debris within the stomach with deformed hyperemic pylorus with no mass seen. Histology of biopsies taken revealed chronic severely active antral predominant gastritis with concurrent Helicobacter pylori and S. ventriculi infection. He subsequently had antibiotic treatment with repeat endoscopy carried out 6 weeks after the initial endoscopy. Repeat biopsy showed the absence of H. pylori and S. ventriculi.
Discussion: The role of S. ventriculi as a pathogen in humans is not clear. As previous reports have shown, S. ventriculi is associated with delayed gastric emptying as seen in the index case. A few cases of coinfection with H. pylori and S. ventriculi have been reported. The histologic features associated with S. ventriculi can range from normal mucosa to acute hemorrhagic gastritis with ulceration; none is pathognomonic. The distinct morphologic features of the organism, basophilic tetrad, or cubes of eight morphologies were demonstrated in the hematoxylin and eosin-stained sections from both the gastric and duodenal biopsy samples from the index patient.
Conclusion: A high index of suspicion is required when carrying out the examination of gastric biopsies obtained from patients with a history of delayed gastric emptying or GI surgery.
Keywords: Delayed gastric emptying, gastritis, Helicobacter pylori, Sarcina ventriculi
