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“Corkscrew”-Associated Gastritis: A Form of Zoonosis!

The so-called “corkscrew”-shaped Helicobacter heilmannii, usually found in cats, pigs, and other primates, is a large (0.5 μm × 5-10 μm), strongly urease-positive, gram-negative rod accounting for 0.2% to 4% of human gastritis cases; hence, it is a candidate for zoonotic infection, along with Campylobacter, Salmonella, Yersinia, Listeria, among others.1-3 It causes a relatively milder form of gastritis clinically and histologically confined to the gastric antrum (Figure 1a and b). They are seen as long, tightly coiled rods with knobby ends, often in clusters in the lumen and not adhering to any foveolar epithelium (Figure 1c and d). Like H. pylori, the organism stains with both polyclonal and monoclonal H. pylori immunohistochemical stains (Figure 1e). Concurrent infection with H. pylori is possible. Polymerase chain reaction amplification of 16S rRNA is the confirmatory test.4,5 However, some evidence suggests that infections with this organism may be more frequently associated with mucosa-associated lymphoid tissue lymphomas.6 The treatment regimen is similar to those used for H. pylori and most cases respond to therapy.