Yersinia enterocolitica: caso di batteriemia in paziente talassemico

Abstract

Infections due to Yersinia enterocolitica,may be acquired by ingestion of contaminated food or water, or rarely, by direct person to person trasmission. Intestinal yersiniosis, the most common infection, may present in three clinical forms: enteritis, terminal ileitis or mesenteric lynphoadenitis (pseudoappendicitis), and septicemia. Septicemia is a rare event, which occurs in adults mostly in association with severe underlying disease: diabetes, cirrhosis,AIDS or neoplastic processes. A particular case is septicemia in patients with iron overload due to thalassemia, or undergoing therapeutic application of iron compounds. In addition, non siderophore producing, serotypes of Y. enterocolitica (0:3 and 0:9), have been isolated from patients treated with desferrioxamine in iron-chelant therapy. As soon as Y. enterocolitica infection is suspected, by clinical symptoms, iron chelation therapy must be immediately stopped and antibiotic treatment must be immediately started. In this paper we describe a Y. enterocolitica bacteriemia in a thalassemic patient, who notices bloody diarrhea, accompanied by high fever and abdominal pain. Y. enterocolitica, isolated from blood cultures of our patient, resulted non siderophore producing serotype 0:3.

Keywords

• Thalassemia, bacteriemia, desferrioxamine, iron-chelant therapy, siderophore, iron-overload