Helicobacter pylori in a Gastric Pit

Robert M. Genta, M.D., and David Y. Graham, M.D.

N Engl J Med 1996; 335:250July 25, 1996

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Figure 1 A 35-year-old man presented with epigastric pain of several months' duration. An esophagogastroduodenoscopy revealed an active duodenal ulcer. Biopsy of the gastric antrum showed chronic active gastritis with innumerable Helicobacter pylori organisms on the gastric mucosa. This photomicrograph of a section of an antral-biopsy specimen (×1000) stained with the Genta stain (a triple stain consisting of a modified Steiner, hematoxylin and eosin, and Alcian blue; pH 2.5) shows a gastric pit virtually filled with H. pylori. Culture confirmed that the infecting organism was H. pylori. The patient was treated for two weeks with omeprazole, clarithromycin, and metronidazole. Endoscopy eight weeks later showed healing of the duodenal ulcer. The cure of H. pylori infection was confirmed by the absence of H. pylori in any of three gastric-biopsy specimens obtained at this time and by a negative urea breath test.

Kim Eagle, M.D.

Robert M. Genta, M.D.
David Y. Graham, M.D.
Veterans Affairs Medical Center, Houston, TX 77030

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