Sarcina ventriculi a rare pathogen

Abstract

Sarcina ventriculi is a gram-positive bacterium, able to survive in extreme low pH environment. It's first description dates from 1842, by John Goodsir. Since then, just a few cases have been reported. In veterinary medicine, especially in ruminants, it causes bloating, vomiting, gastric perforation and death of the animal. It is commonly associated with delayed gastric emptying or obstruction to gastric outlet, although it's pathogenicity in humans is not fully understood. We report two cases with identification of the bacteria in gastric specimens stained with hematoxylin-eosin staining, in different clinical settings. The first patient is a young female patient, presenting cardiac arrest and death after gastric perforation and the second patient an adult male presenting with gastric adenocarcinoma, treated with partial gastrectomy followed by adjuvant chemoradiation. In our literature review, we identified forty-five cases reporting Sarcina ventriculi appearance, with a sudden increase since 2010.

Endoscopic Balloon Dilation of a Pyloric Stricture Caused by Sarcina Ventriculi Infection

“…Sarcina ventriculi is a gram-positive organism rarely encountered as a human pathogen [1], usually reported in association with delayed gastric emptying [2]. There is no established standard treatment.…”

A gastric ulcer: double trouble

“…With great interest, we read the article of Marcelino et al 1 reporting forty-seven cases of Sarcina ventriculi. The article gives an extensive overview of cases describing S. ventriculi appearance, with a sudden increase in cases since 2010.…”

“…However, the clinical presentation is heterogeneous, ranging from asymptomatic to life-threatening conditions. 1 The presence of S. ventriculi together with Helicobacter pylori 2 or after treatment and eradication of H. pylori 3 has been described.…”

“…We would like to add another case to the overview provided by Marcelino et al 1 Our patient, a 40-year-old male, was primarily admitted to the oncology department because of nausea and vomiting due to impaired gastric emptying by stenosis. Computed tomography (CT) scan showed signs suspicious for gastric carcinoma with lymphatic metastasis (Figure 1A).…”

“…There is no established standard treatment for S. ventriculi; the most commonly used regime is the combination of ciprofloxacin and metronidazole. 1 After consultation of a microbiologist, the patient was started on an extended antibiotic treatment of ciprofloxacin and metronidazole for three weeks, in combination with high dose pantoprazole. The patient has not yet been subjected to a subtotal gastrectomy because his condition is improving and he can be properly fed via the jejunostomy tube.…”