{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:33:49Z","timestamp":1753878829029,"version":"3.41.2"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":56,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010<jats:italic>Helicobacter pylori Helicobacter<\/jats:italic> (NHPH) is rarely detected in duodenal mucosa due to its preference for slightly acidic environments. Here, we report four cases of NHPH\u2010infected gastritis with duodenal spiral bacilli, potentially NHPH, indicating the possibility of duodenal mucosal infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>In every case, gastric mucosa showed endoscopic findings characteristic of NHPH\u2010infected gastritis, and a mucosal biopsy was taken from the duodenal bulb; spiral bacilli were identified under microscopy using Giemsa staining. Case 1, a 46\u2010year\u2010old man, had diffuse spotty redness, mucosal edema, and multiple tiny erosions in the duodenal bulb, along with larger erosions in the second portion of the duodenum upon endoscopic examination. Histopathologically, moderate infiltration of mononuclear cells and neutrophils in the lamina propria and gastric epithelial metaplasia were observed. Case 2, a 54\u2010year\u2010old man, showed an elevated lesion, 1\u2009cm in diameter, with multiple red spots and a few tiny erosions in the duodenal bulb. Histopathologically, mild inflammatory cell infiltration and gastric epithelial metaplasia were observed. In Case 3, a 52\u2010year\u2010old man, endoscopy revealed a flat elevated lesion, 7\u2009mm in diameter, with multiple red spots and a few tiny erosions in the anterior wall of the duodenal bulb. Histopathologically, we observed moderate inflammatory cell infiltration in the gastric antrum and gastric epithelial metaplasia in the duodenal bulb. Case 4, a 40\u2010year\u2010old man, showed mild spotty redness in the duodenal bulb. Histopathologically, mild mononucleocyte infiltration and gastric epithelial metaplasia were observed. A single spiral bacillus was observed in Case 4 by microscopy. In all but Case 2, <jats:italic>Helicobacter suis<\/jats:italic> was identified in the gastric juice by polymerase chain reaction analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Spiral bacilli resembling NHPH may infect the duodenal mucosa, particularly the bulb, causing inflammation. Gastric contents entering the duodenum may reduce the intraduodenal pH, promoting NHPH survival and proliferation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13083","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T04:45:26Z","timestamp":1714193126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Four cases of <scp>non\u2010<\/scp><i>Helicobacter pylori Helicobacter<\/i>\u2010infected gastritis with duodenal spiral bacilli"],"prefix":"10.1111","volume":"29","author":[{"given":"Hiroyuki","family":"Agawa","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Kenwakai Hospital  Iida Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1286-1038","authenticated-orcid":false,"given":"Toshihisa","family":"Tsukadaira","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kenwakai Hospital  Iida Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kenwakai Hospital  Iida Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7604-9586","authenticated-orcid":false,"given":"Himiko","family":"Kodaira","sequence":"additional","affiliation":[{"name":"Department of Pathology Kenwakai Hospital  Iida Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyoshi","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Biomedical Laboratory Sciences Shinshu University School of Medicine, School of Health Sciences  Matsumoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehisa","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Biomedical Laboratory Sciences Shinshu University School of Medicine, School of Health Sciences  Matsumoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Shinshu University Hospital  Matsumoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Negishi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Shinshu University Hospital  Matsumoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshifumi","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Japanese Red Cross Society Himeji Hospital  Himeji Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2026337118"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.67.791.846"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12811"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.55.5891"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1699-0463.1997.tb05080.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000197323"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02997390"},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Levels of intragastric and intraduodenal acidity","volume":"14","author":"Atkinson M","year":"1955","journal-title":"Clin 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