A variety of terms may be used to describe a fulminant infectious gastritis - phlegmonous, emphysematous, necrotizing. This is a serious infection with high mortality rate.
Risk factors:
(1) immunosuppression, including HIV disease
(2) neutropenia
(3) alcohol abuse
(4) diabetes mellitus
(5) chronic gastritis
(6) malignancy
(7) gastric mucosal injury, including surgery
Organisms:
(1) Streptococcus pyogenes
(2) Bacillus cereus
(3) Clostridium species
(4) Enterobacteriaceae (Enterobacter, Escherichia coli, Proteus)
Types:
(1) phlegmonous
(2) emphysematous (with gas in gastric wall)
(3) necrotizing (gangrenous)
The infection may be localized or diffuse.
The patient presents initially with nausea, vomiting and epigastric pain. The patient often deteriorates rapidly.
Complications:
(1) septic shock
(2) portal venous pneumatosis
(3) peritonitis
(4) death
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Specialty: Gastroenterology, Infectious Diseases, Surgery, general
