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Case Reports
. 2020 Dec 8;7(12):e00488.
doi: 10.14309/crj.0000000000000488. eCollection 2020 Dec.

Emphysematous Gastritis in a Transplant Recipient With Clostridium ventriculi Infection

David Patrick St Michel  1 , Amy Borth  1 , Jonah Rubin  1 , Naeem Goussous  1 , William Twaddell  1 , Saad Malik  1 , Rolf Barth  1
Affiliations
Case Reports

Emphysematous Gastritis in a Transplant Recipient With Clostridium ventriculi Infection

David Patrick St Michel et al. ACG Case Rep J. .

Abstract

Clostridium ventriculi is a rare infection in poorly controlled diabetic patients with a history of gastroparesis. We present the first documented case in a transplant recipient, who underwent a simultaneous liver kidney transplant. Computed tomography showed emphysematous gastritis, endoscopy revealed gastric necrosis, and microscopy confirmed the diagnosis. Operative intervention was high risk, given the previous liver transplant. Antibiotics and proton pump inhibitor treatment with repeat endoscopy at 4 days showed resolution of gastric necrosis and elimination of microscopic evidence of infection. Combination antibiotic and proton pump inhibitor therapy may be an effective treatment for this rare, life-threatening infection.

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Figures

Figure 1.
Figure 1.
Computed tomography showing emphysematous gastritis (arrows).
Figure 2.
Figure 2.
(A) Initial endoscopy of stomach with ulceration and necrosis and (B) microscopy findings characteristic of Clostridium ventriculi, with tetrads and octets of individual bacterial cells measuring up to 3 μm (arrows).
Figure 3.
Figure 3.
(A) After 4 days of treatment, endoscopy antibiotic and proton pump inhibitor treatment showed resolution of ulcer and improvement in condition of the gastric mucosa and (B) microscopic resolution of Clostridium ventriculi infection.
See this image and copyright information in PMC

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