Multiple spleen and liver abscesses due to Yersinia enterocolitica septicemia in a child with congenital sideroblastic anemia.
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.
Grigull
Lorenz
L
Medizinische Hochschule Hannover, Department of Paediatric Haematology and Oncology, Hannover, Germany. Grigull.Lorenz@mh-hannover.de
Linderkamp
Christin
C
Sander
Annette
A
Schmid
Hansjoerg
H
Mutschler
Ulrich
U
Welte
Karl
K
Beilken
Andreas
A
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*
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D002939:Ciprofloxacin; D000077731:Meropenem