PMC9329004_01
Esophagogastroduodenoscopy images. Endoscopy reveals spotty redness at the gastric fornix (a), mucosal swelling with diffuse redness in the corpus (b), and mucosal atrophy in the gastric angle (c) and antrum (d).
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Subsequently, the patient underwent esophagogastroduodenoscopy, which revealed spotty redness at the gastric fornix (Figure 1(a)), mucosal swelling, diffuse redness in the corpus (Figure 1(b)), and mucosal atrophy at the gastric angle (Figure 1(c)) and antrum (Figure 1(d)).
Histological image. Giemsa stain shows rod-shaped bacteria appearing larger than H. pylori (arrows), suggesting a non-Helicobacter pylori Helicobacter infection.
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IgG antibody test results were negative. Histological examination revealed rod-shaped bacteria that appeared larger than H. pylori (Figure 2, arrows). Infection of non-H. pylori Helicobacter species, such as H. suis and H. heilmannii, was then suspected, and the patient was referred to our hospital for further investigation.
PCR analysis. The presence of H. suis is confirmed using H. suis-specific real-time PCR, targeting ureA and outer membrane protein genes.
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H. suis was further confirmed using H. suis-specific real-time polymerase chain reaction (PCR) targeting ureA and outer membrane protein genes (Figure 3). H. pylori was negative on PCR test.
Esophagogastroduodenoscopy images two months after the eradication therapy. Spotty redness still exists at the gastric fornix (a), while mucosal swelling and diffuse redness are not observed in the corpus (b).
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Esophagogastroduodenoscopy performed two months after eradication therapy showed that spotty redness remained at the gastric fornix (Figure 4(a)), while mucosal swelling and diffuse redness in the corpus disappeared (Figure 4(b)).