Erosive gastritis. H.pylori blood test positive, breath test positive, stool antigen test negative, biopsy negative. What to do?

Treat it. The positive H. pylori antibody test is not a reliable indicator of current infection. The gold standard for H. pylori treatment is the gastric biopsy, and this is negative in this patient. However, I am impressed by the positive breath test and erosive gastritis. I would have expected stool antigen to be positive, as it mirrors the breath test. Given the discrepant results, treat the patient.