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Section 3. Summaries of Infectious Diseases

Helicobacter pylori Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

Helicobacter pylori causes chronic active gastritis and increases the risk of duodenal and gastric ulcers; persistent infection with H pylori increases the risk of gastric cancer. Acute infection can manifest as epigastric pain, nausea, vomiting, hematemesis, and guaiac-positive stools. Symptoms usually resolve within a few days despite persistence of the organism for years or for life. H pylori infection is not associated with autoimmune or chemical gastritis.


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ETIOLOGY

H pylori is a gram-negative, spiral, curved, or U-shaped microaerophilic bacillus that has 2 to 6 sheathed flagella at one end. It is catalase, oxidase, and urease positive.


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EPIDEMIOLOGY

H pylori has been isolated from humans and other primates. An animal reservoir for human transmission has not been demonstrated. Organisms are transmitted from infected humans by the fecal-oral and oral-oral routes. Infection rates are low in children in resource-rich countries except in children from lower socioeconomic groups. Most infections are acquired in the first 5 years of life and can reach a prevalence up to 80% in resource-limited countries. Most . . . [Go to Full Text]