Infectious Diseases and Organisms

Abstract

The discovery that most gastric ulcers and nearly all duodenal ulcers are related to an infectious disease revolutionized the treatment of peptic ulcer disease in the late 20th century. A significant part of our practice involves examining gastric biopsies accompanied by a clinical request to “rule out Helicobacter pylori,” but this is not the only infectious disease that affects the stomach. It is, however, arguably the most important, because it can lead not only to gastric and duodenal ulcers but also to an increased risk for epithelial and lymphoid malignancy. Fortunately, H. pylori gastritis has a characteristic microscopic appearance that allows one to suspect it easily. Other infectious diseases, such as certain viral infections, require a higher index of suspicion and can be challenging to discriminate from other processes in the differential diagnosis.