ro13-9904 and Gastritis

Topics: Ceftriaxone; Clostridioides difficile; Clostridium Infections; Emergencies; Gases; Gastritis; Gastroscopy; Gentamicins; Humans; Laparotomy; Male; Middle Aged; Portal Vein; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome

Acute phlegmonous gastritis is an uncommon disease, often fatal condition characterized by suppurative bacterial infection of the gastric wall. It has a high mortality rate mainly because the diagnosis is usually made late. Until recently, gastrectomy in combination with antibiotics was recommended. We had experienced a case of 66-year-old man presented with epigastric pain, nausea, vomiting, and hematemesis, followed by aspiration pneumonia. At upper gastrointestinal endoscopy, the gastric lumen was narrow, and the mucosa was severely inflamed, which was erythematous, swelled, and showed necrotic areas covered with purulent exudate. Klebsiella oxytoca and Acinetobacter lwoffii were isolated in the gastric tissue culture. Contrast-enhanced computerized tomography scan of abdomen demonstrated diffuse gastric wall thickening and an intramural abscess in the gastric antral wall. Although delayed gastric emptying by gastroparesis prolonged the in-hospital period, the only medical treatment with antibiotics alone successfully cured the patient without gastrectomy.

Topics: Acinetobacter; Acute Disease; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Cefotaxime; Ceftriaxone; Ciprofloxacin; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Gastritis; Gastroparesis; Gastroscopy; Humans; Imipenem; Klebsiella oxytoca; Male; Ofloxacin; Pneumonia; Tomography, X-Ray Computed