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August 1967

Diffuse Phlegmonous Gastritis: A Rare Complication of Pneumococcal Endocarditis

Author Affiliations

Cambridge, Mass

From the Department of Medicine, Mount Auburn Hospital, Cambridge, Mass, and the II and IV (Harvard) Medical Services, Boston City Hospital, Boston. Dr. LaForce is now at the Communicable Disease Center, Atlanta.

Arch Intern Med. 1967;120(2):230-233. doi:10.1001/archinte.1967.00300020102014

BACTERIAL infection of the stomach is a rare occurrence. It may arise from local spread through the mucosa 1 or from hematogenous dissemination from a distant focus.2 The infection may involve a discrete portion of the stomach or may affect the stomach diffusely.3 Of the latter, diffuse phlegmonous gastritis, fewer than 400 cases have been documented in the literature.4

The propensity for generalized embolic infection in patients with pneumococcal endocarditis is well known.5,6 The association of endocarditis and phlegmonous gastritis is unusual, however. Only one case documented by culture of pneumococcal endocarditis and associated diffuse phlegmonous gastritis has been reported.7 Three other cases of suppurative gastritis with endocarditis following pneumonia, presumably pneumococcal, have been described.8-10 The present report of a patient with endocarditis and diffuse phlegmonous gastritis is the second case in which the causative organism was found by culture to be the

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