your lab focus: A Case Report of Gastric Perforation and Peritonitis Associated With Opportunistic Infection by Sarcina ventriculi

Tolentino, Lucilene; Kallichanda, Natash; Javier, Brenda; Yoshimori, Robert; French, Samuel W.

doi:10.1309/cdff-04he-9fhd-qpan

Cited by 24 publications

(58 citation statements)

References 6 publications

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“…These three previously reported cases all showed underlying gastric outlet obstruction and ulcer formation. (13, 16) Two cases had prior medical intervention (bowel reduction secondary to malrotation, and a history of gunshot wound to the anterior chest) which might explain the gastric outlet obstruction. One patient developed gastric perforation and peritonitis, while the other two patients developed emphysematous gastritis.…”

Section: Discussionmentioning

confidence: 99%

“…(17, 18) A few cases of human disease have also been associated with Sarcina organisms, including cases of emphysematous gastritis, peritonitis following gastric perforation, and gastric ulcer. (13, 16) The association of severe human disease with the Sarcina organism raises the question of whether the bacteria are pathogenic in humans. We have collected a series of 5 patients with Sarcina identified in endoscopic biopsies and report the clinicopathologic features, as well as perform DNA sequencing to confirm their identity.…”

Section: Introductionmentioning

confidence: 99%

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Sarcina Organisms in the Gastrointestinal Tract

Lam-Himlin

Tsiatis

Montgomery³

et al. 2011

American Journal of Surgical Pathology

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Sarcina organisms were first observed and recorded in the stomach contents of a patient with vomiting by John Goodsir in 1842. Since that time, the fine structure, phylogenetic classification, and biochemical characteristics have been described. While numerous cases of fatal disease have been attributed to this organism in the veterinary literature, only a few human cases have been documented. As a result, whether this organism causes disease in humans has not been definitively established. We report the clinicopathologic findings in a series of 5 patients with Sarcina-like organisms identified in upper gastrointestinal endoscopic biopsies with molecular confirmation. Based on our findings, the organism is most commonly found in patients with a history of gastric outlet obstruction or delayed gastric emptying. While many of the patients do not demonstrate direct mucosal injury from the organism, the presence of a concurrent gastric ulcer puts the patient at increased risk for complications such as emphysematous gastritis or perforation. The finding of Sarcina organisms should prompt further investigation for functional causes of gastric outlet obstruction and delayed gastric emptying, such as occult malignancy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcina Organisms in the Gastrointestinal Tract

Lam-Himlin

Tsiatis

Montgomery³

et al. 2011

American Journal of Surgical Pathology

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“…The S ventriculi organisms were identified on H&E by their characteristic morphology of a tetrad cellular arrangement, flattening in areas of contact with adjacent cells, and cell walls that are refractile by light microscopy. 3,5 The diagnosis of S ventriculi was further supported by the gram-positive staining pattern ( Figure 3). 6 Separate fragments also had features of reactive gastropathy ( Figure 4) and lamina propria fibrosis.…”

Section: Case Reportmentioning

confidence: 80%

“…S ventriculi has been linked with delayed gastric emptying 3 and postulated to cause emphysematous gastritis 4 and perforation. 5 We present the first reported case of S ventriculi in an asymptomatic patient with prior history of H pylori gastric ulcers.…”

Section: Introductionmentioning

confidence: 87%

A Rare Case of Sarcina ventriculi of the Stomach in an Asymptomatic Patient

2015

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Sarcina ventriculi is a gram-positive coccus that grows in a tetrad arrangement in the stomach. In the past 35 years, less than 20 cases have been reported in the literature, and it has been associated with life-threatening complications such as emphysematous gastritis and perforation. Treatment of S ventriculi generally consists of proton pump inhibitors with or without adjuvant antibiotic therapy. We report the first ever case of S ventriculi, including the morphological and immunohistochemical features, occurring in an asymptomatic patient with a history of Helicobacter pylori gastric ulcers.

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“…97 This bacterium has received some attention in the medical and veterinarian literature because of its association with cases of emphysematous gastritis. 96,[98][99][100] The precise mechanism of injury is uncertain, but in most human cases there is an underlying condition that hampers adequate gastric emptying (gastroparesis, gastric outlet obstruction). 95,101 Carbohydrate stasis, along with the stomach's acidic environment, may provide an ideal medium for S ventriculi growth.…”

Section: Sarcina Ventriculimentioning

confidence: 99%