We report a case of gastric colonization of large spiral-shaped bacteria in a patient with acute gastritis. Endoscopy showed an acute erosive and hemorrhagic gastroduodenitis. Histopathological examination of antral biopsies revealed intense neutrophil infiltrates with microabscesses. Numerous large spiral-shaped bacteria were seen in the Gram-stained smear of the gastric biopsy. The patient was treated with colloidal bismuth subcitrate and cimetidine. Biopsy taken after treatment showed resolution of infection and histological gastritis. The results provide further evidence that large spiral-shaped bacteria are another infective cause of acute neutrophilic gastritis in humans.