Histology

Histology is the gold standard for direct H. pylori detection. Among the eight histology-sampled cases, acute infection was confirmed in three. Five histology-sampled cases showed inflammatory changes consistent with chronic infection but did not meet the formal MSIS neutrophil criterion. Histological sampling was performed in eight cases, while two cases lacked enough suitable material for analysis. In chronic PJI, histology may show lymphocytes and fibrosis rather than the neutrophil pattern required by formal MSIS criteria. Biopsy samples are stained and examined microscopically to identify H. pylori cells. H. pylori's uneven distribution across the stomach lining can also compromise histology results. Recent PPI or antibiotic use can compromise histology results.