Fulminant phlegmonitis of the esophagus, stomach, and duodenum due to Bacillus thuringiensis

Figure 1 Abdominal computed tomography images show rapid progression of gastric wall hypertrophy. Twenty days before onset (A) and at 4 h (B), 6 h (C), and 10 h (D) after onset. Arrowheads in (D) indicate intramural gas.

Figure 2 Endoscopy images show extensive mucosal ischemic change and extension of the necrosis. A: Lower esophagus; B: Cardia; C: Gastric corpus; D: Duodenum.

Figure 3 Gram staining of gastric juice from the patient (original magnification × 1000). Arrows indicate Bacillus thuringiensis.