P3423 - Example of Zoonosis: Gastritis Caused by Helicobacter heilmannii Infection

Paloria Terrell, DO¹, Chase Dugay, MD¹, Jefferson Tran, ², Thomas Tran, MD^1
1TMC, Denison, TX; ²TMC, Sherman, TX

Introduction: Zoonosis is an infectious disease that is transmitted from animals to humans. Helicobacter heilmannii infection is rare in humans but is common in animals such as dogs and cats. We report a case of gastritis caused by Helicobacter heilmannii acquired from house pets.

Case Description/Methods: The patient is a 41-year-old man with a history of asthma who presented with one year of intermittent dysphagia and reflux disease. He underwent an EGD which showed diffuse gastritis. Gastric biopsies were performed. There was a moderate stricture at the distal esophagus which was treated by balloon dilation up to 20 mm. There were findings of eosinophilic esophagitis such as concentric rings, furrows, and white plaques. Antral pathology showed chronic superficial gastritis. Immunostaining showed Helicobacter heilmannii infection. Esophageal pathology was consistent with eosinophilic esophagitis. On follow up, the patient disclosed that he had 2 cats and 2 dogs at home. After discussion with the patient, we decided to treat the Helicobacter heilmannii infection first. Quadruple therapy with 14 days of amoxicillin 500 mg po bid, clarithromycin 500 mg po bid, pantoprazole 40 mg po bid, and bismuth subsalicylate 30 ml po bid was initiated. Since H. heilmannii status cannot be determined by the stool antigen test or urease breath test, a repeat EGD was done 6 months later. Antral biopsies showed complete eradication of the infection. Esophageal biopsies again showed eosinophilic esophagitis, for which monoclonal antibody treatment with dupilumab was planned.

Discussion: Zoonotic transmission of Helicobacter heilmanii is has been increasingly recognized as a mode of infection from animals to humans. Despite having a low prevalence, Helicobacter heilmannii infection in humans is associated with gastric pathology in the form of peptic ulcer disease, gastric carcinoma, and gastric MALT (mucosa-associated lymphoid tissue) lymphoma. A study by Stolte et al showed that the risk of MALT lymphoma is higher with Helicobacter heilmannii infection when compared with Helicobacter pylori. Because this poses a significant health issue, future efforts should focus on reliable diagnosis and pathogenesis of Helicobacter heilmannii infections. Clinicians should be aware of Helicobacter heilmannii infection, as illustrated by this case report.


Disclosures:


Paloria Terrell, DO¹, Chase Dugay, MD¹, Jefferson Tran, ², Thomas Tran, MD¹. P3423 - Example of Zoonosis: Gastritis Caused by <i>Helicobacter heilmannii</i> Infection, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.