Successful Antimicrobial Treatment of Phlegmonous Gastritis: A Case Report and Literature Review

Table 1

Pertinent findings from our review of 25 case reports.

Author/Year	Sex	Age	Cause/risk factor	Symptoms	Pathogen/s	Diagnosis	Intervention/management	Complications	Result
Ajibe H, 2008	M	74	Endoscopic submucosal dissection for gastric adenocarcinoma	Epigastric pain, fever	Citrobacter freundii, Enterobacter cloacae, and Streptococcus	CT, EGD, EUS	Antibiotics, total gastrectomy	Nil	Discharge
Alonso et al., 2013 [7]	F	55	None	Chest pain	Streptococcus pyogenes	CT	Antibiotics, endoscopic abscess drainage	Nil	Discharge
Fan JQ, 2013	M	65	Esophagectomy for esophageal adenocarcinoma	Fever, dyspnea	Nil	CT, EGD	Antibiotics	Nil	Discharge
Flor-de‐Lima F, 2015	M	7	Acute tonsillitis	Epigastric pain, nausea, vomiting	Streptococcus pneumoniae, EBV	CT, EGD with biopsy	Antibiotics	Nil	Discharge
Guo et al., 2009 [3]	M	57	CML, myeloid sarcoma	Dyspnea, chest pain, abdominal pain, fatigue	VRE	CT, EGD with biopsy, autopsy	Antibiotics	Upper GI bleed	Death
Huang et al., 2017 [5]	F	60	Uncontrolled DM	Fever, fatigue, chest pain	Pseudomonas, Klebsiella	CT, EGD	Antibiotics, surgery (not gastrectomy)	Hypopharyngeal abscess, esophageal perforation	Discharge
Ishigami T, 2008	M	70	None	Fever, abdominal pain	MDR Streptococcus	EGD	Antibiotics	Nil	Discharge
Itonaga M, 2012	F	70	EUS-FNA for pancreatic tumor	Fever, abdominal pain	Alpha-hemolytic Streptococcus	Ct, EGD, EUS	Antibiotics	Nil	Discharge
Kato et al., 2015 [1]	M	64	DM, chronic pancreatitis	Epigastric pain, nausea	Peptostreptococcus	CT, EGD with biopsy	Antibiotics, EUS-guided pseudocyst drainage	Nil	Discharge
Kim BY, 2017	M	51	Ankylosing spondylitis	Nausea, vomiting	Nil	CT, EGD	Antibiotics	Nil	Discharge
Kim et al., 2010 [9]	M	48	Alcoholism, uncontrolled DM	Fever, chest pain, abdominal pain, dyspnea	Klebsiella spp.	EGD	Antibiotics, surgery (not gastrectomy)	Bilateral pleural effusions	Discharge
Kim et al., 2016 [2]	M	74	Alcoholic cirrhosis, DM, recent EGD, gastric adenocarcinoma	Abdominal pain, vomiting	Nil	CT, EGD with biopsy	Antibiotics	Nil	Discharge
Kim NY, 2011	M	66	None	Epigastric pain, nausea, vomiting	Klebsiella, Acinetobacter	CT, EGD with biopsy	Antibiotics	Nil	Discharge
Liu YJ, 2013	M	84	Colon cancer, prostate cancer	Fever, nausea, vomiting	Polymicrobial (gram positive and gram negative organisms)	CT, exploratory laparotomy gastric biopsy	Antibiotics, gastrectomy	Nil	Discharge
Matsumoto H, 2015	M	74	Myelofibrosis, multiple myeloma, neutropenia	Epigastric pain, nausea	Bacillus spp.	CT, EGD	Antibiotics	Sepsis, disseminated intravascular coagulation	Death
Min et al., 2014 [6]	F	51	Gastric ulcer	Abdominal pain	Streptococcus pyogenes	CT, exploratory laparotomy	Antibiotics, total gastrectomy	Gastric submucosal dissection	Discharge
Morimoto et al., 2014 [4]	M	77	DM, gastric ulcers	Fever, nausea, vomiting	Group A Streptococcus	CT	Antibiotics		Death
Nomura K, 2015	F	80	None	Epigastric pain, vomiting	Enterobacter cloacae and Enterococcus faecium	CT, EGD with biopsy	Antibiotics, total gastrectomy (worsening gastric strictures)	Nil	Discharge
Paik DC, 2010	M	45	Recent paranasal sinus surgery	Abdominal pain, nausea, vomiting	Streptococcus pyogenes	CT, exploratory laparotomy EGD	Antibiotics	Respiratory failure, renal failure, coagulopathy	Discharge
Park CW, 2010	F	73	Gastric outlet narrowing	Epigastric pain, abdominal distension	E. coli, Acinetobacter	CT, EGD with biopsy	Antibiotics, pyloric stent	Nil	Discharge
Rada-Palomino et al., 2014 [8]	M	62	HIV	Epigastric pain, hematemesis, diarrhea	Streptococcus pyogenes	CT, EGD with biopsy	Antibiotics	Nil	Discharge
Saito M, 2012	F	55	ALL	Neutropenia	Bacillus spp.	CT, EGD with biopsy	Antibiotics	Nil	Discharge
Sakata T, 2011	F	63	None	Fever	None reported	CT, EGD with biopsy	Antibiotics, drainage	Nil	Discharge
Shiozawa K, 2009	M	62	Uncontrolled DM	Epigastric pain	None reported	CT	Antibiotics, drainage	Nil	Discharge
Munroe CA, 2010	M	58	Chronic hepatitis B	Epigastric pain, nausea, fever	Alpha-hemolytic Streptococcus	CT, EGD, EUS with biopsy	Antibiotics, aspiration	Nil	Discharge

CML: chronic myeloid leukemia; DM: diabetes mellitus; HIV: human immunodeficiency virus; ALL: acute lymphoblastic leukemia; EBV: Epstein-Barr virus, VRE: vancomycin-resistant Enterococcus; MDR: multidrug resistance; Strep: Streptococcus; EUS: endoscopic ultrasound; CT: computed tomography; EGD: esophagogastroduodenoscopy; FNA: fine needle aspiration.