Emphysematous gastritis due to Sarcina ventriculi infection in a diabetic liver-kidney transplant recipient
Autops. Case Rep
;
10(2): e2020164, Apr.-June 2020. graf
Article
in English
| LILACS
| ID: biblio-1131820
ABSTRACT
Emphysematous gastritis (EG) is a rare and potentially lethal process caused by invasive, gas-producing bacteria leading to inflammation and gas dissection of the stomach. The most common etiologic agents are Clostridium infections, but other organisms, including enterobacteria, staphylococcus, and fungi have also been identified. We report the first case of EG due to Sarcina ventriculi in a solid organ transplant recipient, who presented with epigastric pain and vomiting. The patient had a history of type 1 diabetes mellitus (DM) with recurrent episodes of ketoacidosis and systemic diabetic complications, including severe gastroparesis. CT scan studies demonstrated EG with venous air, and endoscopy showed severe gastritis and ulcerations. In the gastric biopsies, abundant Sarcina ventriculi were noted in areas of mucosal/submucosal necrosis. Antibiotic treatment was instituted at admission, and subsequent endoscopy demonstrated the disappearance of Sarcina, with some improvement of the gastric inflammation; however, the patient developed septic shock with multiorgan failure and expired. This case highlights the need to consider other infectious etiologies in transplant patients, in addition to the well-known opportunistic infections.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Diabetes Complications
/
Transplant Recipients
/
Infections
Type of study:
Etiology study
/
Prognostic study
Limits:
Adult
/
Humans
Language:
English
Journal:
Autops. Case Rep
Journal subject:
Anatomia
/
Patologia Cl¡nica
/
Patologia Legal
Year:
2020
Type:
Article
Affiliation country:
United States
Institution/Affiliation country:
University of Maryland School of Medicine/US
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