Yersinia enterocolitica bacteremia in a chronically transfused patient with sickle cell anemia. Case report and review of the literature.
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.
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Department of Pediatrics, New York University Medical Center, New York City 10016.
Puder
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DR
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
D002443:Ceftriaxone; D003676:Deferoxamine