A Rare Cause of Upper Gastrointestinal Bleeding: Sarcina ventriculi

We describe a patient who presented with hematemesis and was found to have unusually well-demarcated erythematous mucosa with a 2–3 cm irregular nonbleeding necrotic ulcer in the gastric body on esophagogastroduodenoscopy. Biopsy and pathologic examination of the tissue indicated infection with a rare bacterium, Sarcina ventriculi, prompting treatment with an unproven combination of 4 agents: metronidazole, ciprofloxacin, sucralfate, and pantoprazole. Repeat esophagogastroduodenoscopy 8 weeks later revealed complete resolution of the ulceration and surrounding erythema. These results may contribute toward establishing an appropriate therapeutic regimen for future S. ventriculi infections.