Yersinia enterocolitica bacteremia in a chronically transfused patient with sickle cell anemia. Case report and review of the literature.

F Blei, D R Puder
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Abstract

Purpose: Yersinia enterocolitica sepsis is rarely encountered in patients without an underlying susceptibility and is most frequently reported in iron-overloaded patients. This is thought to be related to the unusual utilization of iron by this microorganism. We report a case of Y. enterocolitica bacteremia in a chronically transfused adolescent with sickle cell anemia. This type of serious infection in sickle cell disease is previously unreported. A description of the case and the relationship between Y. enterocolitica and iron is discussed. A review of the literature is presented.

Results: Y. enterocolitica can cause a severe septicemia, and increased virulence of this organism has been shown to correlate with increased iron burden and/or use of the chelator deferoxamine. It may also occur as a consequence of a contaminated blood transfusion.

Conclusions: We believe our case demonstrates that Y. enterocolitica should be considered a possible pathogen in febrile chronically transfused patients with sickle cell disease. Broad antibiotic coverage should be initiated and deferoxamine discontinued pending results of cultures.

镰状细胞性贫血慢性输血患者的小肠结肠炎耶尔森菌血症。病例报告及文献复习。
目的:小肠结肠炎耶尔森菌败血症很少发生在没有潜在易感性的患者中,最常报道的是铁负荷过重的患者。这被认为与这种微生物对铁的不同寻常的利用有关。我们报告一例小肠结肠炎菌血症在长期输血青少年镰状细胞性贫血。这种镰状细胞病的严重感染以前未见报道。本文讨论了该病例的描述以及小肠结肠炎与铁之间的关系。本文对相关文献进行了综述。结果:小肠结肠炎耶氏菌可引起严重的败血症,该菌的毒力增加已被证明与铁负荷增加和/或螯合剂去铁胺的使用有关。输血受污染也可能导致感染。结论:我们认为,我们的病例表明,小肠结肠炎应被视为发热慢性输血患者镰状细胞病可能的病原体。应开始广泛使用抗生素,停止使用去铁胺,等待培养结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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