S6461 Helicobacter heilmannii, an Unusual Suspect of Gastritis and Abdominal Pain

Introduction: Helicobacter heilmannii (HH), a non-Helicobacter pylori Helicobacter (NHPH) is an infrequent cause of gastritis and duodenal ulcers with higher prevalence in developing countries. This bacterium is generally found in primates, dogs, cats, and infection in humans is acquired through a zoonotic transmission. Most of the infected patients suffer from chronic active gastritis but is also a sporadic cause of gastric erosions and gastric cancer has been reported as well. Literature review confirms a stronger association between the occurrence of Gastric Mucosa-associated Lymphoid T (MALT) Lymphoma with Non- Helicobacter pylori Helicobacters (NHPH). Even though H. heilmannii-associated gastritis is uncommon and milder than H. pylori-associated gastritis, it may be noteworthy with respect to the development of MALT lymphoma. H. heilmannii infection is treated with standard anti-H. pylori treatment with emphasis on measures to prevent reinfection from pets. Case Description/Methods: A 53-year-old woman with history of essential hypertension, hyperlipidemia presented with complaints of epigastric abdominal discomfort, fullness associated with nausea and bloating for months. She had complaints of epigastric pain but denied any history of vomiting, diarrhea. She denied any history of fever and weight loss Dietary modifications and proton pump inhibitors didn’t improve her symptoms and was referred to Gastroenterology for further work-up. Endoscopy showed normal examination of the stomach showed only mild patchy inflammation of gastric antrum and normal duodenum. Biopsies were taken from multiple sites of the stomach and duodenum. Histopathology of the Gastric Antral and body/fundus mucosa showed moderate chronic gastritis and numerous Helicobacter heilmannii. Treatment with a course of triple therapy confirmed resolution of symptoms. Discussion: H. pylori is the most common gastric colonizing bacterium found in humans that causes various gastritis. H. heilmannii, a Helicobacter species found in the stomach of domestic Animals. H. heilmannii-associated gastritis in the human stomach has been rarely reported. Patients may report nonspecific symptoms of epigastric pain, dyspepsia, nausea, vomiting. H. heilmannii induces mild chronic gastritis but is infrequently associated with peptic ulceration and rarely with mucosa-associated lymphoid tissue lymphoma H. heilmannii is treated with standard anti-H. pylori treatment with emphasis on measures to prevent reinfection from pets.