ABSTRACT
Sarcina ventriculi is an increasingly common gram-positive coccus, recognized in gastric biopsies, particularly of patients with delayed gastric emptying. It occurs most commonly in adult women and can be identified easily by its characteristic morphologic features, such as basophilic staining, cuboid shape, tetrad arrangement, red blood cell-sized packets, flattened cell walls, and refractile nature on light microscopy. Although the pathogenesis of the organism is debated, it has been implicated in cases of gastric perforation, emphysematous gastritis, and peritonitis as well as occurring in the background of gastric adenocarcinomas. This review of the literature discusses the clinical features, endoscopy findings, histopathology, ancillary studies, microbiology, pathogenesis, differential diagnosis, treatment, and prognosis of this bacterium based on 19 published cases.
Subject(s)
Clostridium Infections/diagnosis , Sarcina/isolation & purification , Anti-Infective Agents/therapeutic use , Clostridium Infections/drug therapy , Clostridium Infections/microbiology , Clostridium Infections/physiopathology , Diagnosis, Differential , Drug Therapy, Combination , Emphysema/etiology , Emphysema/prevention & control , Female , Gastric Emptying/drug effects , Gastritis/etiology , Gastritis/prevention & control , Humans , Male , Metronidazole/therapeutic use , Peritonitis/etiology , Peritonitis/prevention & control , Prognosis , Sarcina/drug effects , Sarcina/pathogenicity , Stomach Rupture/etiology , Stomach Rupture/prevention & control , Vomiting/etiology , Vomiting/prevention & controlSubject(s)
Adenocarcinoma/diagnosis , Carcinoma, Squamous Cell/diagnosis , Prostatic Neoplasms/diagnosis , Sarcoma/diagnosis , Acid Phosphatase/analysis , Adenocarcinoma/complications , Adenocarcinoma/pathology , Biomarkers, Tumor/analysis , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/pathology , Histocytochemistry , Humans , Immunohistochemistry , Kallikreins/analysis , Male , Microscopy , Middle Aged , Prostate/pathology , Prostate-Specific Antigen/analysis , Prostatic Neoplasms/pathology , Sarcoma/complications , Sarcoma/pathology , Tumor Suppressor Protein p53/analysis , Vimentin/analysisABSTRACT
Sarcina ventriculi is a gram-positive coccus that grows in a tetrad arrangement in the stomach. In the past 35 years, less than 20 cases have been reported in the literature, and it has been associated with life-threatening complications such as emphysematous gastritis and perforation. Treatment of S ventriculi generally consists of proton pump inhibitors with or without adjuvant antibiotic therapy. We report the first ever case of S ventriculi, including the morphological and immunohistochemical features, occurring in an asymptomatic patient with a history of Helicobacter pylori gastric ulcers.
Subject(s)
Gram-Positive Bacterial Infections/microbiology , Sarcina , Stomach Diseases/microbiology , Female , Gram-Positive Bacterial Infections/pathology , Humans , Middle Aged , Stomach Diseases/pathologyABSTRACT
A 38-year-old man presenting with long bone/rib fractures was diagnosed with tumor-induced osteomalacia (TIO) caused by a giant cell tumor in the right foot with normal systemic fibroblast growth factor-23 (FGF23) levels. Multiple imaging modalities done initially and one year later were unable to localize the tumor. New-onset foot pain discovered a right foot mass with resolution of metabolic abnormalities post-surgery. Sampling from both femoral veins showed an elevated FGF23 value on the right side. This case is unique in that the patient had a normal systemic FGF23 level even with severe clinical manifestations of TIO.
