TWO CASE REPORT OF HELICOBACTER HEILMANNII GASTRITIS WITH ENDOSCOPIC FEATURES RESEMBLING HELICOBACTER PYLORI GASTRITIS

Abstract

Helicobacter Heilmannii (also known as gastrospirillum hominis) has been reported as the cause of gastritis. We report two cases of helicobacter heilmanni gastritis with endoscopic features resembling helicobacter pylori gastritis. Our patients were 4 and 11 year old children who presented with history of severe abdominal pain, vomiting which required multiple visits to the emergency department and in one case an admission to the hospital. Both patients had work up that included electrolytes, amylase, lipase, and liver function tests which failed to identify the cause of their symptoms. Radiological evaluation was negative for anatomical obstruction. One patient had normal abdominal ultrasound. Patients were seen in consultation by the pediatric gastroenterology service two weeks after the onset of the symptoms. both patients underwent esophagogastroduodenoscopy. Both patients had evidence of active gastritis with nodular gastric mucosa which resembled the appearance of helicobacter pylori (HP) gastritis. The pathological evaluation was negative for HP and positive for the presence of corkscrew-like spiral bacteria compatible with helicobacter helmannii. One patient had Clotest and HP antibodies tests done and both were negative. Both patients were treated with H2 blocker, clarithromycin and amoxicillin with remarkable resolution of symptoms within few days. Conclusion: Helicobacter heilmannii (HH) gastritis is a cause of acute abdominal pain in children. HH gastritis has an endoscopic appearance that resembles HP gastritis. HH gastritis seems to respond well to treatment with H2 blockers, clarithromycin and amoxicillin.