Enterohepatic Non-H. pylori Helicobacter Infection in a Patient With X-Linked Agammaglobulinemia

Hannah R Chang; Daniel Whitehurst; Elizabeth P Schlaudecker; Sharon Karunakaran; Kerith E Spicknall; Catherine Bridges

doi:10.1111/pde.70099

Enterohepatic Non-H. pylori Helicobacter Infection in a Patient With X-Linked Agammaglobulinemia

Pediatr Dermatol. 2025 Nov 20. doi: 10.1111/pde.70099. Online ahead of print.

Authors

Hannah R Chang¹, Daniel Whitehurst², Elizabeth P Schlaudecker², Sharon Karunakaran², Kerith E Spicknall³, Catherine Bridges⁴

Affiliations

¹ University of Texas Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
² Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
³ Department of Dermatology, University of Cincinnati, Cincinnati, Ohio, USA.
⁴ Division of Dermatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

PMID: 41263135
DOI: 10.1111/pde.70099

Abstract

Non-H. pylori Helicobacter (NHPH) species are gram-negative, microaerophilic, spiral-shaped bacteria that can rarely cause recurrent bacteremia, cellulitis, and pyoderma gangrenosum-like ulcers, particularly in immunocompromised individuals such as those with X-linked agammaglobulinemia (XLA). We present a case of a 21-year-old male with XLA who presented with painful, recurrent, firm, indurated cutaneous plaques on the upper and lower extremities, initially suspected to have eosinophilic fasciitis. Diagnosis of NHPH bacteremia was confirmed using both 16S rRNA sequencing and the Karius test, a plasma-based next-generation sequencing platform that detects microbial cell-free DNA, and symptoms resolved after successful treatment of the organism. This case raises awareness for NHPH-induced fasciitis in the differential diagnosis of painful, recurrent atypical, indurated plaques in patients with XLA.

Keywords: Helicobacter bilis; Helicobacter cinaedi; X‐linked agammaglobulinemia; fasciitis; next‐generation sequencing; non‐H. pylori Helicobacter (NHPH).

Publication types

Case Reports