Micro & Immunology · patient case question
Which microorganism is responsible for the majority of peptic ulcers?
Patient case: Medical history review before treatment
Patient: 60-year-old patient completing a medical history update.
Chief complaint: Routine care.
History: Reports a diagnosis of peptic ulcer disease treated some years ago, and current treatment with atorvastatin for hyperlipidemia.
Findings: No acute dental findings. History review only.
Show answer and explanation
Correct answer: A. Helicobacter pylori
- A. CORRECT. HELICOBACTER PYLORI, a gram-negative spiral bacterium, colonizes gastric mucosa and produces urease, neutralizing acid around itself and damaging the mucosal barrier. It accounts for the large majority of duodenal and gastric ulcers not caused by NSAIDs. Relevant dentally: NSAID analgesia should be used cautiously in ulcer patients.
- B. S. pyogenes causes pharyngitis, erysipelas and skin infection.
- C. C. difficile causes antibiotic-associated pseudomembranous colitis, a colonic disease.
- D. E. coli causes urinary and enteric infection, not peptic ulceration.
Note: NSAID use is the other major cause. Together, H. pylori and NSAIDs account for the large majority of peptic ulcers, which is a relevant consideration when prescribing analgesics for this patient.
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