[Helicobacter heilmanni (Gastrospirillum hominis) as a new cause of gastritis--case report].

INTRODUCTION

During the course of research into Helicobacter pylori, further microorganisms colonizing the gastric mucosa have been detected. The large spiral-shaped bacteria deviating from Helicobacter pylori was originally described by Dent. The bacteria was initially named Gastrospirillum hominis, but after sequencing of 16S rRNA it was classified as Helicobacter and named Helicobacter Heilmannii in honour of the pathologist Prof. Dr. Konrad Heilmann. We report two additional cases.

CASE REPORTS: In 1997 at the Department of Pathology of General Hospital in Senta 268 gastric biopsies (151 male, 117 female), average age of 50.4 were analyzed. Helicobacter pylori was identified in 176 biopsies (65.7%). Helicobacter Heilmannii was found in two cases (0.74%). The clinical details were as follows: Case 1. A 32-year-old male complained of dyspepsia. Esophagogastroduodenoscopy disclosed hyperemia and scattered erosions in the lower third of stomach. Case 2. a 55-year-old female was admitted at the hospital with lumbar pain, loss of appetite and body weight. Esophagogastroduodenoscopy findings were normal. The patient lived in rural household in contact with various domestic animals. In the biopsy specimens of both cases in the antral gastric mucosa large bacteria resembling a corkscrew were found, 6-10 microns length, consisting of 5-9 regular tight spiral. The bacteria were midly eosinophilic and Gram negative. The bacteria stained strongly with the Warthin-Starry silver stain, and with Giemsa stain. The distribution of Helicobacter Heilmannii was patchy in the central zones of the gastric pits, deep or more superficial including the foveolar opening on the mucosal surface. A mild degree of chronic gastritis characterized both cases, with, focally active inflammation and lymphoid aggregates. None of biopsies had atrophy, intestinal metaplasia or epithelial damage. There was a symptomatic improvement after a 4-week course with triple therapy (H2 antagonist & metronidazole & amoxycillin). After treatment rebiopsy specimens displayed mild chronic gastritis and no spiral organisms.

CONCLUSION

Our reported cases are the first described cases of gastritis caused by Helicobacter Heilmannii in our region with successful eradication after therapy. Morphologically similar bacteria have been found in the stomachs of domestic animals. It is a general opinion that Helicobacter Heilmannii is characteristic for animals but it is occasionally transmitted to humans.