Sarcina Ventriculi infection: a rare but fearsome event. A Systematic Review of the Literature

Abstract

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Non-operative Management of Sarcina ventriculi-Associated Severe Emphysematous Gastritis: A Case Report

“…How Sarcina over-proliferates in the body or why it causes fatal complications in some individuals and not others need to be further elucidated. Some of the cases cited in this report have also indicated delayed gastric emptying either from diabetes or gastric surgery, immunocompromised state, and concomitant Candida infections in their patients with Sarcina , which may play a role in its growth [ 1 , 10 , 21 ]. In our patient, delayed gastric emptying likely played a role in his complications judging by the gastric contents still seen during the EGD.…”

“…A systematic review of the literature for Sarcina infections showed that out of 66 reported cases, about 53% received antimicrobial therapy and 20% of the cases received proton pump inhibitors (PPIs) with 88% eradication on follow-up EGD. Surgical treatment was performed in 23% of cases for gastric perforation, necrosis, stenosis, and massive pneumoperitoneum [ 1 ]. Surgical interventions included partial gastrectomy, fundoplication and hiatal hernia repair, perforation primary repair, jejunostomy, ileocecal resection with ileostomy, and fistula excision [ 1 ].…”

“…Surgical treatment was performed in 23% of cases for gastric perforation, necrosis, stenosis, and massive pneumoperitoneum [ 1 ]. Surgical interventions included partial gastrectomy, fundoplication and hiatal hernia repair, perforation primary repair, jejunostomy, ileocecal resection with ileostomy, and fistula excision [ 1 ]. What is also unclear in our patient is the role of his recent surgery and the etiology of gangrenous cholecystitis in this subacute presentation post-operatively.…”

“…There are around 65 reported cases of Sarcina ventriculi in humans [1] that have been associated with emphysematous gastritis [6][7][8][9], delayed gastric emptying [10], and fatal gastric perforation [11]. The exact pathogenesis is still unclear.…”

“…Sarcina ventriculi , also known as Clostridium ventriculi , is a non-motile, anaerobic, Gram-positive coccus [ 1 ] with distinct morphological features, including a cuboid shape, tetrad arrangement, and basophilic staining [ 2 ]. Due to its survivability in low pH environments [ 3 ], this bacterium has been implicated in fatal epizootic, neurologic, and gastroenteric syndromes in chimpanzees [ 4 ] and acute gastric dilatation (AGD) in canines and equines [ 5 ].…”