<i>Sarcina ventriculi</i> associated gastritis: a rare finding in dyspepsia

A 35-year-old woman presented with dull, non-radiating upper abdominal pain for last one month, associated with loss of appetite and unintentional weight loss. Physical and laboratory examinations were unremarkable. An upper gastrointestinal biopsy was done for further evaluation, which revealed erythematous mucosa of gastric antrum. Histopathological examination on H&E showed characteristic basophilic, tetrad arrangements of Sarcina ventriculi. The patient was treated with pantoprazole, with metronidazole and ciprofloxacin for 7 days. Follow-up showed improvement with symptom resolution and normal repeat endoscopy after a month. Awareness of the distinctive histological appearance of Sarcina ventriculi is important for clinicians, and should be on the differential for cases presenting with unexplained upper gastrointestinal symptoms.