Acute Helicobacter pylori infection in an infant, associated with gastric ulceration and serological evidence of intra-familial transmission.

Reports of the clinical picture and laboratory findings associated with naturally acquired acute H. pylori infection are rare and, although family studies have suggested person-to-person transmission, there have been no accounts of serologically proven intra-familial spread. This report describes the clinical and histological features associated with acute H. pylori infection in an infant and includes serological evidence for the possible transmission of this organism within his direct family. The infant, who presented with acute vomiting and severe haemetemesis, was found on endoscopy to have two shallow ulcers in the gastric antrum. Evidence of H. pylori infection was provided by the urease test, histology, and serology, the latter two tests showing the infection to be acute. Serologically, the patient's mother was shown to have an established H. pylori infection prior to her son, his twin brother to have acquired the infection shortly before the patient, and his father to have become infected some 63 days after the patient. Information on the acute presentation of H. pylori in children and evidence of the spread of H. pylori within family members is presented.