Zhang JL, Wei N, Chen TM, Qiu W. Triple infection of gastric syphilis, Helicobacter pylori and human immunodeficiency virus: A case report. World J Gastroenterol 2026; 32(11): 115809 [DOI: 10.3748/wjg.v32.i11.115809]
Corresponding Author of This Article
Wen Qiu, Department of Gastroenterology, 363 Hospital, No. 108 Daosangshu Street, Wuhou District, Chengdu 610041, Sichuan Province, China. 347921527@qq.com
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Gastroenterology & Hepatology
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Case Report
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Mar 21, 2026 (publication date) through Apr 5, 2026
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World Journal of Gastroenterology
ISSN
1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhang JL, Wei N, Chen TM, Qiu W. Triple infection of gastric syphilis, Helicobacter pylori and human immunodeficiency virus: A case report. World J Gastroenterol 2026; 32(11): 115809 [DOI: 10.3748/wjg.v32.i11.115809]
World J Gastroenterol. Mar 21, 2026; 32(11): 115809 Published online Mar 21, 2026. doi: 10.3748/wjg.v32.i11.115809
Triple infection of gastric syphilis, Helicobacter pylori and human immunodeficiency virus: A case report
Jing-Li Zhang, Na Wei, Tian-Ming Chen, Wen Qiu
Jing-Li Zhang, Department of Pathology, 363 Hospital, Chengdu 610041, Sichuan Province, China
Na Wei, Tian-Ming Chen, Wen Qiu, Department of Gastroenterology, 363 Hospital, Chengdu 610041, Sichuan Province, China
Wen Qiu, Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Co-first authors: Jing-Li Zhang and Na Wei.
Co-corresponding authors: Tian-Ming Chen and Wen Qiu.
Author contributions: Zhang JL and Wei N contributed equally to this work as co-first authors and they designed the report and conducted resources; Chen TM and Qiu W wrote the manuscript and they are the co-corresponding authors of this manuscript; all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the 363 Hospital Medical Research Project Incubation Program, No. 2024FH002; and Joint Innovation Fund of Health Commission of Chengdu and Chengdu Medical College, No. WXLHCXJJ25-55.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying figures.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Received: October 27, 2025 Revised: December 24, 2025 Accepted: January 16, 2026 Published online: March 21, 2026 Processing time: 141 Days and 20.6 Hours
Abstract
BACKGROUND
Gastric syphilis (GS) is a rare infection caused by Treponema pallidum (T. pallidum) and may mimic neoplasia or be overlooked. Co-infection with Helicobacter pylori (H. pylori) and human immunodeficiency virus (HIV) has not previously been reported.
CASE SUMMARY
A 17-year-old woman presented with upper abdominal pain for two weeks. A large irregular-shaped ulcer on the antrum was identified by endoscopy and the C-14 breath test was positive. Quadruple therapy was given to eradicate H. pylori, but her symptoms persisted after treatment. No significant improvement in the antral ulcer was found on secondary gastroscopy. Gynecologic examination observed characteristic vulvar syphilis. Serum tests revealed that she was co-infected with syphilis and HIV. Immunohistochemistry (IHC) staining confirmed the coexistence of H. pylori and T. pallidum in gastric mucosa biopsy. The gastric symptoms rapidly disappeared after anti-syphilis treatment, and she was finally diagnosed with GS, H. pylori and HIV triple infection.
CONCLUSION
GS should be considered in any patient with an atypical or therapy-refractory gastric ulcer, particularly when serological syphilis positivity exists. IHC is a reliable method for confirming intra-gastric T. pallidum. Clinical doctors need to collaborate with pathologists to clarify diagnosis.
Core Tip: We describe the first case of gastric syphilis, Helicobacter pylori (H. pylori) and human immunodeficiency virus triple infection. The report highlights that syphilis can produce severe “tumor-like” gastric ulceration; moreover, co-infection must be identified when H. pylori eradication fails.
