{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T19:40:43Z","timestamp":1757706043264,"version":"3.41.2"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,8,18]],"date-time":"2017-08-18T00:00:00Z","timestamp":1503014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002457","name":"Chosun University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002457","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Aside from <jats:italic>Helicobacter pylori<\/jats:italic>, another cause for the development or worsening of gastrointestinal ulcers is scrub typhus, an acute febrile disease caused by <jats:italic>Orientia tsutsugamushi<\/jats:italic>. We aimed to compare the endoscopic characteristics of peptic ulcers caused by these infectious agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective case\u2010control study involved patients who underwent upper gastrointestinal endoscopy at Chosun University Hospital in Korea. We compared endoscopic features and demographic characteristics between patients with <jats:italic>H.\u00a0pylori<\/jats:italic> infection and those with <jats:italic>O. tsutsugamushi<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 141 patients with peptic ulcer were included in the study. Compared to patients with <jats:italic>O. tsutsugamushi<\/jats:italic> infection (n\u00a0=\u00a062; age, 63.8\u00a0\u00b1\u00a012.1\u00a0years; male sex, 42%), those with <jats:italic>H. pylori<\/jats:italic> infection (n\u00a0=\u00a079; age, 53.0\u00a0\u00b1\u00a014.8\u00a0years; male sex, 81%) were younger and more likely to be male (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 for both). Patients with <jats:italic>O. tsutsugamushi<\/jats:italic> infection were more likely to have multiple lesions (40\/62, 64.5% vs 37\/79, 46.8%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.042) and irregular\u2010shaped lesions (27\/62, 43.6% vs 20\/79, 25.3%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.031). Patients with <jats:italic>H. pylori<\/jats:italic> infection had higher incidence of hemorrhagic ulcers (26\/79, 32.9% vs 8\/62, 12.9%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.007), and lesions occurred most often in the duodenum (43.0%), followed by the antrum (36.7%), body (34.2%), and angle (12.7%) of the stomach. In patients with <jats:italic>O. tsutsugamushi<\/jats:italic> infection, lesions occurred most often in the antrum (70.97%), followed by the duodenum (35.5%), body (22.6%), and angle (14.5%) of the stomach. In both groups, gastric ulcer lesions occurred most often in the antrum, followed by the body and angle of the stomach (36.7% vs 70.97%, 34.2% vs 22.6%, and 12.7% vs 14.5% for gastric ulcers associated with <jats:italic>H. pylori<\/jats:italic> and <jats:italic>O. tsutsugamushi<\/jats:italic> infection, respectively). Patients with <jats:italic>O. tsutsugamushi<\/jats:italic> infection had significantly higher incidence of ulcers on the antrum (70.97% vs 36.7%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and the greater curvature (45.2% vs 24.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.012). Finally, 35.5% of patients with gastric ulcer caused by scrub typhus also had duodenal ulcer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study to compare endoscopic features of peptic ulcers caused by <jats:italic>H. pylori<\/jats:italic> and <jats:italic>O. tsutsugamushi<\/jats:italic>. Peptic ulcers in patients with <jats:italic>H. pylori<\/jats:italic> infection occurred predominantly in the antrum\/body\/lesser curvature and presented with single, round\/oval lesions, while ulcers in patients with scrub typhus occurred predominantly in the antrum\/greater curvature and presented with multiple, irregular lesions. Scrub typhus should be considered as a cause of duodenal ulcer in scrub typhus\u2010endemic areas.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12427","type":"journal-article","created":{"date-parts":[[2017,8,18]],"date-time":"2017-08-18T08:34:14Z","timestamp":1503045254000},"source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic characteristics of infection\u2010associated peptic ulcers"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3011-8507","authenticated-orcid":false,"given":"Seong\u2010Hyung","family":"Choi","sequence":"first","affiliation":[{"name":"Chosun University College of Medicine Internal Medicine  Gwangju Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong\u2010Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Chosun University College of Medicine Internal Medicine  Gwangju Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Lee","sequence":"additional","affiliation":[{"name":"Chosun University College of Medicine Internal Medicine  Gwangju Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na Ra","family":"Yun","sequence":"additional","affiliation":[{"name":"Chosun University College of Medicine Internal Medicine  Gwangju Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0889-8553(21)00260-0","article-title":"Microbiology of Helicobacter pylori","volume":"22","author":"Goodwin CS","year":"1993","journal-title":"Gastroenterol Clin North Am"},{"issue":"2","key":"e_1_2_8_3_1","first-page":"33","article-title":"The prevalence of Helicobacter pylori infection in different countries","volume":"9","author":"Pounder RE","year":"1994","journal-title":"Aliment Pharmacol Ther"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(77)80271-0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1128\/jvi.64.5.2168-2174.1990","article-title":"Is herpes simplex virus associated with peptic ulcer disease?","volume":"64","author":"L\u00f6hr JM","year":"1990","journal-title":"J Virol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(31)90657-0"},{"key":"e_1_2_8_7_1","first-page":"769","article-title":"Primary gastric tuberculosis: a case report and literature review","volume":"82","author":"Subei I","year":"1987","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_8_1","first-page":"18","article-title":"Antigenic diversity of Rickettsia tsutsugamushi: epidemiologic and ecologic significance","volume":"12","author":"Elisberg BL","year":"1968","journal-title":"J Hyg Epidemiol Microbiol Immunol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/596576"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022731"},{"key":"e_1_2_8_11_1","first-page":"1035","article-title":"Ranitidine bismuth citrate therapy","volume":"10","author":"Harris A","year":"1996","journal-title":"Aliment Pharmacol Ther"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.167_b.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.01214.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2008.00344.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i3.706"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1005433"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.04219.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(02)70376-3"},{"issue":"2","key":"e_1_2_8_19_1","first-page":"59","article-title":"The prevalence of Helicobacter pylori in peptic ulcer disease","volume":"9","author":"Kuipers EJ","year":"1994","journal-title":"Aliment Pharmacol Ther"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90374-7"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.40.4.463"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529409105353"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0155810"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.14-0478"}],"container-title":["Helicobacter"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhel.12427","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.12427","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T20:18:43Z","timestamp":1695759523000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hel.12427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,18]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/hel.12427"],"URL":"https:\/\/doi.org\/10.1111\/hel.12427","archive":["Portico"],"relation":{},"ISSN":["1083-4389","1523-5378"],"issn-type":[{"type":"print","value":"1083-4389"},{"type":"electronic","value":"1523-5378"}],"subject":[],"published":{"date-parts":[[2017,8,18]]},"article-number":"e12427"}}