Case Study 67 Pathogenic Bacteriology 2009.pptVIP

Case Study 67Pathogenic Bacteriology2009 Rochelle Songco Omar Ahmed Hank Hsieh Case Summary Patient: 60 year old female with a past history of gastric ulcer Symptoms of dyspepsia – pressure in the upper abdominal area that radiated to chest and neck Upper GI series showed radiologic findings of thickened fold within the stomach Outpatient esophagogastroduodenoscopy (EGD) was performed Biopsy of antral part of the stomach was consistent with moderate gastritis. No tumor was seen 3+ to 4+ of bacterial organism was found Case Summary Key Information Pointing to Diagnosis Presence of bacterial organism Evidence of moderate gastritis visualized in biopsy Past medical history of gastric ulcer Symptoms of dyspepsia and abdominal pain The Diagnosis for Case 67 Disease is chronic gastritis The causative organism is Helicobacter pylori Confirmed by histopathologic examination of biopsy specimen Classification,Gram Stain Results, and Microscopic Appearance of H. pylori Gram negative Small, curved bacilli Multiple unipolar flagella Microaerophilic Similar to Campylobacter except for its ability to produce urease Diseases and Pathogenesis of Disease Caused by H. pylori Diseases Chronic, active gastritis Peptic ulcers Symptoms are epigastric pain, nausea, vomiting, and anorexia Risk factor for gastric cancer and lymphoma Pathogenesis of disease Urease - enables the survival of H. pylori in a low pH environment of the stomach lumen Degrades urea to ammonia and carbon dioxide. Ammonia is alkaline and neutralizes the acid fluid in the stomach Flagella – allows penetration through viscous mucous layer where conditions for growth are better Pathogenesis of Disease Caused by H. pylori CagA – syringe-like structure that injects itself into host epithelial cells Activates signal transduction pathways and cell growth Strains containing CagA have a higher inflammatory response and higher risk for peptic ulcer and gastric cancer Vacuolating cytotoxin (VacA) – causes membra