A Rare Case of Sarcina ventriculi of the Stomach in an Asymptomatic Patient

Abstract

Sarcina ventriculi is a gram-positive coccus that grows in a tetrad arrangement in the stomach. In the past 35 years, less than 20 cases have been reported in the literature, and it has been associated with life-threatening complications such as emphysematous gastritis and perforation. Treatment of S ventriculi generally consists of proton pump inhibitors with or without adjuvant antibiotic therapy. We report the first ever case of S ventriculi, including the morphological and immunohistochemical features, occurring in an asymptomatic patient with a history of Helicobacter pylori gastric ulcers.

Coinfection of Sarcina ventriculi and Candida in a patient of gastric outlet obstruction: An overloaded pyloric antrum

“…Therefore, this infectious organism must be eradicated when associated with other pathology . The gastric biopsies may be histologically unremarkable or exhibit ulceration with diffuse, acute hemorrhagic gastritis . In this case, chronic gastritis was noted.…”

“…On light microscopy, the morphological features that help to identify S. ventriculi are its cuboidal shape, basophilic staining on hematoxylin–eosin stain, flattening of cell walls in areas of contact with adjacent cells, and the characteristic arrangement as tetrad packet or octets which are formed because of replication that takes place in at least two planes of growth. This organism may also be mistaken for vegetable matter by a novice because of its refractile nature . S. ventriculi can be differentiated from Staphylococcus and Micrococcus species, which are smaller in size and are present in tight clusters .…”

“…Patients with superficial Candidiasis respond to proton pump inhibitors and do not require antifungal agents . Eradication of these bacteria should be confirmed by repeat endoscopy after treatment of infection …”

A rare case of Sarcina ventriculi diagnosed on fine‐needle aspiration

“…Impaired gastric emptying could potentially lead to the growth of S ventriculi organisms, which are acid tolerant and use the retained food for fermentative metabolism . In addition to gastric biopsies, S ventriculi has been reported in cytology samples including brushing cytology of the esophagus and stomach and one case of FNA of pyloric ulcer . In our patient, delayed gastric emptying was a result of GOO due to pyloric strictures caused by prior ulcers.…”

“…Sarcina ventriculi is linked with conditions causing delayed gastric emptying and have been associated with abdominal pain, nausea, peptic ulcer, and diarrhea, and rarely life‐threatening complications such as gastric perforation and emphysematous gastritis . Sarcina ventriculi has also been reported in gastric specimens from asymptomatic patients . Here, we report a case of S ventriculi infection diagnosed by fine‐needle aspiration (FNA) of the pancreas and gastric pyloric biopsies.…”