title: Multiple spleen and liver abscesses due to Yersinia enterocolitica septicemia in a child with congenital sideroblastic anemia.
abstract: In patients with iron overload, opportunistic infections are an underestimated risk. Yersinia enterocolitica is a rare organism to be isolated in this setting. The authors report a case of disseminated Y. enterocolitica sepsis in a 5-year-old boy with sideroblastic anemia. Ultrasound examination revealed massive ascites, a pseudo-appendicitis, and hypoechogenic lesions corresponding to abscess formations in the liver and spleen. The initial antibiotic therapy consisted of cefotaxime, gentamicin, and metronidazole, but only treatment with ciprofloxacin and meropenem led to defervescence and clinical stabilization. The risk of developing uncommon infections in patients with iron overload should be acknowledged by all physicians, and the relevance of ultrasound examination is emphasized. In this case, only a detailed history revealed that several days before the onset of diarrhea, the child was feeding a deer; this is how infection was probably acquired.
authors.affiliation: Medizinische Hochschule Hannover, Department of Paediatric Haematology and Oncology, Hannover, Germany. Grigull.Lorenz@mh-hannover.de
authors.forename: Lorenz
authors.initials: L
authors.lastname: Grigull
authors.forename: Christin
authors.initials: C
authors.lastname: Linderkamp
authors.forename: Annette
authors.initials: A
authors.lastname: Sander
authors.forename: Hansjoerg
authors.initials: H
authors.lastname: Schmid
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mutschler
authors.forename: Karl
authors.initials: K
authors.lastname: Welte
authors.forename: Andreas
authors.initials: A
authors.lastname: Beilken
mesh_terms: D000756:Anemia, Sideroblastic / Q000151:congenital* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use; D006801:Humans; D019190:Iron Overload / Q000209:etiology; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D000077731:Meropenem; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D013845:Thienamycins / Q000627:therapeutic use; D065227:Transfusion Reaction; D014463:Ultrasonography; D015009:Yersinia Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D015008:Yersinia enterocolitica / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D002939:Ciprofloxacin; D000077731:Meropenem