There are conflicting reports on whether this organism is found in healthy human stomachs. Some authors favored this theory, 23 whereas others, such as Canale-Parola, 13 suggest that, although it was originally observed in stomach contents, this organism is not found in the healthy human stomach.
Growth of S ventriculi takes place in the human stomach because of delayed gastric emptying from pathologic conditions such as diabetic gastroparesis, gastric surgeries, scarring, pyloric stenosis, 13 or an obstructing mass. With these diseases, the acidic pH of the stomach, and the presence of carbohydrates and other growth nutrients contained in food, S ventriculi thrives and multiplies rapidly.
Therefore, Lam-Himlin et al 5 suggested that a preexisting mucosal defect provided the nidus for emphysematous gastritis to develop, rather than direct invasion of Sarcina species into the gastric wall. Although the role of S ventriculi as the mechanism of mucosal injuries in these cases is not clear, the local accumulation of acetaldehyde and ethanol formed from carbohydrate fermentation by the organism could induce stomach and duodenal injuries, similar to the acetaldehyde-induced mucosal injuries in acute alcohol ingestion.
Furthermore, the carbon dioxide production from glucose fermentation and pyruvate metabolism results in abdominal distention in some of these patients. The tetrad or packet-forming arrangement is not unique to Sarcina organisms, and the main differential diagnosis upon light microscopy is with Micrococcus species, which is also a gram-positive coccus that occurs in tetrads or packets.
Other differential diagnoses for S ventriculi are Sarcina maxima and Staphylococcus species. The most helpful feature in light microscopy to differentiate S ventriculi from S maxima is the thick extracellular layer present on the outer surface wall of S ventriculi , which is not observed in S maxima.
This layer generally measures to nm in thickness and is composed of mostly of cellulose or a closely related compound. The recent increase in reports of Sarcina organisms supports the observation by Sopha et al 10 underscoring the need to define a standard regimen for its treatment.
Medlicott and Adams 26 outlined a treatment approach based on the clinical status of the patient. If the patient is clinically stable and healthy, they suggested it was reasonable to forego treatment because the organism can occur commensally. If, however, the patient is symptomatic, particularly with prominent dysphagia or substernal burning, treatment with a proton pump inhibitor and a prokinetic was indicated.
If there is evidence of associated gastric erosion or similar acute conditions, eradication of the organism with antibiotics was recommended. In conclusion, S ventriculi is an increasingly common, gram-positive bacterium, seen predominantly in patients with delayed gastric emptying.
Presence of S ventriculi has been associated with cases of gastric perforation and emphysematous gastritis, and although the pathogenicity of this organism is not entirely certain, its recognition in an endoscopic biopsy raises important diagnostic and therapeutic considerations.
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Volume , Issue Previous Article. Article Navigation. This Site. Google Scholar. Carmencita G. Senseng, MD Carmencita G. Senseng, MD. Arch Pathol Lab Med 12 : — Get Permissions. Cite Icon Cite. Table 1. View large. View Large. Table 2. View large Download slide. Influence of pH extremes on sporulation and ultrastructure of Sarcina ventriculi. Search ADS. XXIII: history of a case in which a fluid periodically ejected from the stomach contained vegetable organisms of an undescribed form.
Sarcina organisms in the gastrointestinal tract: a clinicopathologic and molecular study. The constant occurrence of Sarcina ventriculi Goodsir in the blood of man and the lower animals: with remarks on the nature of sarcinous vomiting.
A case report of gastric perforation and peritonitis associated with opportunistic infection by Sarcina ventriculi. A rare case of Sarcina ventriculi of the stomach in an asymptomatic patient. An experiment with Sarcina ventriculi. Vol Possible involvement of Sarcina ventriculi in canine and equine acute gastric dilatation. Clues to uncommon and easily overlooked infectious diagnoses affecting the GI tract and distinction from their clinicopathologic mimics.
An average bacillus is 0. Spirals come in one of three forms , a vibrio, a spirillum, or a spirochete. There are exceptions to the three basic shapes of coccus, bacillus, and spiral. They include sheathed, stalked, filamentous , square, star-shaped, spindle-shaped, lobed, trichome-forming , and pleomorphic bacteria. Ultrasmall bacteria could fit in a single Escherichia coli have been discovered in groundwater that was passed through a filter with a pore size of 0.
They showed an average length of only nanometers nm and an average width of nm. They contain DNA, an average of 42 ribosomes per bacterium, and possessed pili. It is thought that they use these pili to attach to other bacteria from which they scavenge nutrients. Because the surface to volume ratio is even greater than in more traditional sized bacteria, they might be better designed to take up scarce nutrients from more nutrient-poor environments.
Learning Objectives List the three basic shapes of bacteria. List and describe 5 different arrangements of cocci. Define and give the abbreviation for the metric unit of length termed micrometer and state the average size of a coccus-shaped bacterium and a rod-shaped bacterium. List and describe 2 different arrangements of bacilli. List and describe 3 different spiral forms of bacteria. The rod or bacillus Bacilli are rod-shaped bacteria.
The spiral Spirals come in one of three forms , a vibrio, a spirillum, or a spirochete. Exceptions to the above shapes There are exceptions to the three basic shapes of coccus, bacillus, and spiral. Ultrasmall Bacteria Ultrasmall bacteria could fit in a single Escherichia coli have been discovered in groundwater that was passed through a filter with a pore size of 0.
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