Incidentally Detected Persistent Helicobacter heilmannii Gastritis in a Korean Woman With a Normal Endoscopic Examination: Successful Eradication After Salvage Therapy
- 1College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, USA
- 2Gastroenterology, Borland Groover, Jacksonville, USA
Abstract
Helicobacter heilmannii is an uncommon, non-Helicobacter pylori gastric organism associated with chronic gastritis, peptic ulcer disease, gastric mucosa-associated lymphoid tissue lymphoma, and gastric adenocarcinoma. Because the stomach may appear normal endoscopically, diagnosis often depends on histologic examination. Presented is a 59-year-old Korean woman with intermittent epigastric pain and heartburn, as well as a maternal family history of gastric cancer. Upper endoscopy demonstrated a small hiatal hernia with an otherwise normal-appearing stomach. Antral biopsies showed moderate chronic active gastritis with H. heilmannii colonization without metaplasia, dysplasia, or malignancy. The patient was treated with clarithromycin-based triple therapy, with symptomatic improvement. Repeat upper endoscopy with gastric mapping four months later demonstrated persistent H. heilmannii infection. She then completed 14 days of optimized bismuth quadruple therapy. An additional follow-up upper endoscopy with gastric mapping four months later showed normal gastric histology without residual Helicobacter.
This highlights the potential for H. heilmannii infection despite a normal endoscopic appearance, the limitations of symptomatic response as evidence of eradication, and the importance of repeat gastric biopsies after treatment failure.
Related
- Helicobacter pylori Infection in Rome IV Functional Dyspepsia: Association with the Epigastric Pain Syndrome Phenotype and Long-Term Response to Eradication
- Efficacy and Safety of Tegoprazan–Amoxicillin Dual Therapy for Helicobacter pylori Eradication: A Systematic Review and Meta‐Analysis With Trial Sequential Analysis of Randomized Controlled Trials
- Gastric Cancer: Global Epidemiology, Risk Factors, Helicobacter pylori Eradication, and Risk-Based Screening
- Antimicrobial Resistance-Stratified Efficacy of Vonoprazan, Clarithromycin, and Metronidazole Therapy for Helicobacter pylori Eradication in Penicillin-Allergic Patients: A Single-Arm Prospective Interventional Study.
- Recurrence of Helicobacter Pylori after Successful Eradication in Northwestern China: Rates, Risk Factors, and Resistance Profiles of Recurrence Isolates.
BibTeX
@article{flanagan2026incidentally,
title = {{Incidentally Detected Persistent Helicobacter heilmannii Gastritis in a Korean Woman With a Normal Endoscopic Examination: Successful Eradication After Salvage Therapy}},
author = {Makaela G Flanagan and Michael Herman},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117180},
url = {https://europepmc.org/article/PMC/PMC13719439},
note = {CC BY},
}
RIS
TY - JOUR
TI - Incidentally Detected Persistent Helicobacter heilmannii Gastritis in a Korean Woman With a Normal Endoscopic Examination: Successful Eradication After Salvage Therapy
AU - Makaela G Flanagan
AU - Michael Herman
PY - 2026
DA - 2026/09/29
JO - Cureus
DO - 10.7759/cureus.117180
UR - https://europepmc.org/article/PMC/PMC13719439
AB - Helicobacter heilmannii is an uncommon, non-Helicobacter pylori gastric organism associated with chronic gastritis, peptic ulcer disease, gastric mucosa-associated lymphoid tissue lymphoma, and gastric adenocarcinoma. Because the stomach may appear normal endoscopically, diagnosis often depends on histologic examination. Presented is a 59-year-old Korean woman with intermittent epigastric pain and heartburn, as well as a maternal family history of gastric cancer. Upper endoscopy demonstrated a small hiatal hernia with an otherwise normal-appearing stomach. Antral biopsies showed moderate chronic active gastritis with H. heilmannii colonization without metaplasia, dysplasia, or malignancy. The patient was treated with clarithromycin-based triple therapy, with symptomatic improvement. Repeat upper endoscopy with gastric mapping four months later demonstrated persistent H. heilmannii infection. She then completed 14 days of optimized bismuth quadruple therapy. An additional follow-up upper endoscopy with gastric mapping four months later showed normal gastric histology without residual Helicobacter. This highlights the potential for H. heilmannii infection despite a normal endoscopic appearance, the limitations of symptomatic response as evidence of eradication, and the importance of repeat gastric biopsies after treatment failure.
SN - 2168-8184
ER -