EC Gastroenterology and Digestive System

Sarcina ventriculi, a Gram-positive organism, which has been reported in gastric specimens of patients with delayed gastric emptying, in most cases the organism was found incidentally or with mild gastrointestinal symptoms such as nausea. We report three cases of S. ventriculi, the second and third cases are of partial gastric outlet obstruction and the other case presented with post GJ status. Endoscopic biopsies was performed and the final histopathological examination revealed the presence of S. ventriculi organisms coexisting with H. pylori in the mucosal biopsies in two of our cases. S. ventriculi, association with life-threatening conditions like partial gastric outlet obstruction and emphysematous gastritis, requires identification and documentation of this organism in the final histopathological report as the patient may need further workup.

Keywords: Gastric Outlet Obstruction; Sarcina ventriculi; Emphysematous Gastritis

1. Goodsir J. “XXIII: history of a case in which a fluid periodically ejected from the stomach contained vegetable organisms of an undescribed form”. Journal of Natural History 11 (1843): 125-126.
2. Gaspar BL. “The significance of Sarcina in routine surgical pathology practice”. APMIS 124 (2016): 436-443.
3. Lam-Himlin D., et al. “Sarcina organisms in the gastrointestinal tract: a clinicopathologic and molecular study”. The American Journal of Surgical Pathology 35 (2011): 1700-1705.
4. Louis GB., et al. “Sarcina infection”. BMJ Case Reports (2014).
5. Kumar M., et al. “Co-infection of Sarcina and Giardia in a child”. Oxford Medical Case Reports (2014): 118-119.
6. Bhagat P., et al. “A rare association of Sarcina with gastric adenocarcinoma diagnosed on fine-needle aspiration”. Journal of Cytology 32 (2015): 50-52.
7. Chougule A., et al. “Pulmonary Gangrene Due to Rhizopus spp., Staphylococcus aureus, Klebsiella pneumonia and Probable Sarcina Organisms”. Mycopathologia 180 (2015): 131-136.
8. Sauter JL., et al. “Coexistence of Sarcina organisms and Helicobacter pylori gastritis/duodenitis in pediatric siblings”. Journal of Clinical and Anatomic Pathology 1 (2013): 1-3.
9. Laass MW., et al. “Emphysematous gastritis caused by Sarcina ventriculi”. Gastrointestinal Endoscopy 72 (2010): 1101-1103.
10. Haroon Al Rasheed., et al. “Sarcina ventriculi: Review of the Literature”. Archives of Pathology and Laboratory Medicine 140 (2016): 1441-1445.
11. Ananthanaryan R and Paniker CKJ. “Staphylococcus”. In: Textbook of Microbiology. 6th edition. Hyderabad, India: Orient Longman (2002): 178.
12. Propst R., et al. “Sarcina Organisms in the Upper Gastrointestinal Tract: A Report of 3 Cases with Varying Presentations”. International Journal of Surgical Pathology 28 (2020): 206-209.
13. Zare SY., et al. “A rare case of Sarcina ventriculi diagnosed on fine-needle aspiration”. Diagnostic Cytopathology 47 (2019): 1079-1081.
14. Singh K. “Emphysematous Gastritis Associated with Sarcina ventriculi”. Case Reports in Gastroenterology 13 (2019): 207-213.
15. Dey B., et al. “Sarcina in Sputum Cytology in a Patient of Pulmonary Tuberculosis”. Journal of Cytology 36 (2019): 219-221.
16. Aggarwal S., et al. “Coinfection of Sarcina ventriculi and Candida in a patient of gastric outlet obstruction: An overloaded pyloric antrum”. Diagnostic Cytopathology 46 (2018): 876-878.
17. Shetty NU., et al. “First documented case of Sarcina in esophageal brushing cytology”. Diagnostic Cytopathology 46 (2018): 886-887.
18. Tim GJ De Meij., et al. “Budding Ulcerative Gastritis and Esophagitis in Two Children with Sarcina ventriculi Infection”. Frontiers in Medicine 4 (2017): 145.