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Helicobacter heilmannii s.l. and peptic ulcer disease – A rare cause
Helicobacter heilmannii s.l. y úlcera péptica, una causa rara
Marisa Linhares
, Flávio Pereira, Diana Ramos, Rui Sousa
Corresponding author
Department of Gastroenterology, Amato Lusitano Hospital, Castelo Branco, Portugal
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In January 2019, she was admitted in emergency room for epigastric pain and hematemesis. An upper endoscopy was performed, diagnosing one deep gastric ulcer, prepyloric (Forrest IIb), measuring about 50<span class="elsevierStyleHsp" style=""></span>mm, and another duodenal ulcer (Forrest IIc), circumferential that extended between pylorus and D2 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The patient was hospitalized and treated with proton pump inhibitor.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The gastric ulcer endoscopic and histologic follow up, showed a progressive improvement (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) and no evidence of malignancy, respectively. However, only in the third biopsy samples was demonstrated the presence of <span class="elsevierStyleItalic">Helicobacter heilmannii sensu latu</span> (<span class="elsevierStyleItalic">H. heilmanni s.l.</span>) bacterium (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Patient was treated with quadruple eradication therapy.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Currently, upper endoscopy showed the gastric ulcer resolution and histologic samples confirmed the eradication of the bacteria. Patient is asymptomatic.</p><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">H. Heilmannii s.l.</span> is a non-H. <span class="elsevierStyleItalic">Pylori</span> helicobacter that may be considered a zoonosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Despite its low prevalence (<1%) in humans, this pathogen has been reported to cause peptic ulcer, gastric MALT-lymphoma and gastric carcinoma; and gastric symptom.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1–2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The authors highlight this case for its rarity and to reinforce the importance of repeating gastric ulcers.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 600 "Ancho" => 1500 "Tamanyo" => 153569 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Prepyloric gastric ulcer, Forrest IIb (left); circumferential duodenal ulcer Forrest IIc (right).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 720 "Ancho" => 900 "Tamanyo" => 103764 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prepyloric gastric ulcer, almost complete, resolution after 3 months endoscopic follow up.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 647 "Ancho" => 1500 "Tamanyo" => 140073 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Gastric biopsy samples with bacteria lengthier than <span class="elsevierStyleItalic">H</span>. <span class="elsevierStyleItalic">pylori</span>, stained with modified giemsa (400×), corresponding to <span class="elsevierStyleItalic">Helicobacter heilmannii S.l</span>. specimens (arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Helicobacter heilmannii sensu lato: an overview of the infection in humans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Bento-Miranda" 1 => "C. Figueiredo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v20.i47.17779" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2014" "volumen" => "20" "paginaInicial" => "17779" "paginaFinal" => "17787" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25548476" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Helicobacter pylori-negative peptic ulcer: what is its aetiopathogenesis and treatment?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Monés Xiol" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Enfermedades Dig" "fecha" => "2002" "volumen" => "94" "paginaInicial" => "692" "paginaFinal" => "696" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack563548" "titulo" => "Acknowledgments" "texto" => "<p id="par0030" class="elsevierStylePara elsevierViewall">Thanks are due to Dr. Domingos Oliveira and Dr. Rui Caetano Oliveira for providing the histopathologic pictures for the case.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/02105705/0000004400000009/v1_202110240545/S0210570520303290/v1_202110240545/en/main.assets" "Apartado" => array:4 [ "identificador" => "75365" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes del mes" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02105705/0000004400000009/v1_202110240545/S0210570520303290/v1_202110240545/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520303290?idApp=UINPBA00004N" ]
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