Acute hemorrhagic gastropathy with multiple shallow ulcers and duodenitis caused by a laboratory infection of Helicobacter pylori,☆☆,,★★

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Case Report

The patient was one of the authors (T. T.), a 32-year-old male bacteriologist who volunteered to be a subject for the research of H. pylori, who was a non-smoker and a social drinker. No medicines or alcohol had been taken for 1 month before the onset of the symptoms. He had no history of gastroduodenal diseases or any other dyspeptic symptoms in the past. He first had an attack of mild mid-epigastric cramps, followed by exacerbating upper abdominal pain, heartburn, and epigastric fullness on

Characterization and identification of the isolated strain

Polymerase chain reaction (PCR) amplification for the cagA fragments was carried out using the previously reported primers DZ3 and R009,14 and primers F1 and B1.15 An assessment of the vacuolating cytotoxin activity (VCA) was carried out as described by Xiang et al.14 The antisera were produced with recombinant CagA and VacA proteins purified from Escherichia coli. The PCR-based restriction fragment length polymorphism (RFLP) analysis of the ureC gene in H. pylori was carried out as previously

Results

The patient was H. pylori–negative 87 days before the onset of the symptoms. The phenotypes of the two virulence factors of the isolated strain were negative for cag A gene and CagA protein based on a PCR and Western blot study, respectively, while vacuolating cytotoxicity (VacA) based on an HeLa cell assay was positive. We therefore compared the PCR-RFLP pattern of ureC of H. pylori among the isolates and 12 other strains of CagA–/VacA+ phenotype that the patient had handled in the laboratory

Discussion

The clinical course of the present case was similar to that of the previously reported cases of acute infection with H. pylori.6, 23 The patient could not specifically recall any particular instance of mishandling in the laboratory and therefore the route of infection in this case is still unknown. We could not estimate the dose of the ingested bacteria, but the small amount of H. pylori observed in the biopsy sample suggested it was smaller than the one used in the experimental studies.

The

Acknowledgment

The antisera, produced with recombinant CagA and VacA proteins purified from E. coli, were kindly supplied by Dr. Antonello Covacci, IRIS, Italy.

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  • Cited by (0)

    From the Department of Laboratory Medicine and First Department of Internal Medicine, Faculty of Medicine, Fukuoka University; and Department of Bacteriology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

    ☆☆

    Supported in part by a grant-in-aid for the Encouragement of Young Scientists from The Ministry of Education, Science, Sports and Culture of Japan, Mitsui Life Social Welfare Foundation, and funds from the Central Research Institute of Fukuoka University.

    Reprint requests: Tohru Takata, MD, Department of Laboratory Medicine, Faculty of Medicine, Fukuoka University, Nanakuma 7–45–1 Jonan-ku, Fukuoka S 814–0180, Japan.

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