Gastrointestinal infection by Mycobacterium avium with an unusual endoscopic presentation.

A 38-year-old male with medical history of HIV group C3 with voluntary abandonment of antiretroviral therapy, was hospitalized due to general deterioration, abdominal pain, diarrhea and rectal bleeding without signs of acute abdomen. The patient presented anemia, renal and hepatic dysfunction, and metabolic acidosis. Abdominal CT and CT angiography were performed without observing signs of perforation or active bleeding. In the same year, he was also diagnosed of intestinal Cryptosporidiosis, cutaneous Kaposi's sarcoma and disseminated infection by Mycobacterium avium (MA) with lung, liver and bone marrow involvement. Panendoscopy was performed, showing violaceous lesions on the soft palate. In the stomach and duodenum, he presented multiple, large, well-defined and occasionally confluent red-violet lesions Colonoscopy did not show macroscopic alterations.

Total gastrectomy due to emphysematous and necrotizing gastritis associated with Sarcina ventriculi in an 18-year-old patient.

An 18-year-old woman with no pathological history, admitted to Emergency Department with abdominal pain and vomiting after consuming alcohol and cannabis in the last 36 hours. On physical examination, she presented with abdominal distention, signs of peritoneal irritation and sepsis. Abdominal computed tomography showed gastric, esophageal and duodenal distension, gastric and portal pneumatosis and the presence of free intra-abdominal fluid. An exploratory laparotomy was performed revealing extensive gastric necrosis. Then, total gastrectomy with stapled Roux-en-Y anastomosis was required. Histopathology of the gastric tissue confirmed extensive images of transmural emphysematous and necrotizing gastritis, and allowed to identify established Sarcina ventriculi infection.