title: Yersinia enterocolitica bacteremia in a chronically transfused patient with sickle cell anemia. Case report and review of the literature.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatrics, New York University Medical Center, New York City 10016.
authors.forename: F
authors.initials: F
authors.lastname: Blei
authors.forename: D R
authors.initials: DR
authors.lastname: Puder
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy; D001803:Blood Transfusion; D002443:Ceftriaxone / Q000627:therapeutic use; D003676:Deferoxamine / Q000627:therapeutic use; D004198:Disease Susceptibility; D006432:Hemochromatosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D015009:Yersinia Infections / Q000150:complications* / Q000188:drug therapy; D015008:Yersinia enterocolitica
chemical_list: D002443:Ceftriaxone; D003676:Deferoxamine