11/135. Septic arthritis of the hip caused by yersinia enterocolitica: a case report.We report a case of bacteriologically documented hip infection caused by yersinia enterocolitica. A 67-year-old male with a history of valvular disease was admitted for pain and motion range limitation in the left hip with a fever. No organisms were recovered by needle aspiration, but yersinia enterocolitica grew in joint fluid obtained by surgical arthrotomy. Investigations of the gastrointestinal tract were normal, and there was no evidence of endocarditis. After 6 weeks of appropriate antibiotic therapy and immobilization with transtibial traction, the clinical and laboratory test abnormalities improved. However, the patient died from an intercurrent condition. Y. enterocolitica, a well-known cause of reactive arthritis, can cause septic arthritis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
12/135. Yersinia septic shock following an autologous transfusion in a pediatric patient.Although the literature on infections transmitted via transfused blood focuses on viruses, yersinia enterocolitica can also cause severe infections in patients receiving transfusions. A 13-year-old patient developed severe sepsis after an autologous blood transfusion contaminated with Y. enterocolitica. The patient was an otherwise healthy female undergoing posterior spinal fusion for congenital scoliosis. Prior to surgery, the patient donated blood for perioperative and postoperative use. A few days before the donation, she had complained of abdominal pain and was experiencing mild diarrhea. The patient received four units of packed red blood cells (PRBCs) during the surgery. Intraoperatively, the patient developed fever up to 103.6 degrees F, became hypotensive requiring epinephrine and dopamine, and developed metabolic acidosis with serum bicarbonate concentration dropping to 16 mmol/l. The surgery team believed the patient was experiencing malignant hyperthermia and attempted to cool patient during the procedure. Postoperatively, the patient was transferred to the pediatric intensive care unit and treated for severe shock of unknown etiology. The patient further developed disseminated intravascular coagulation. The patient received supportive care and was started on ampicillin/sulbactam on postoperative day (POD) one which was changed to clindamycin, ciprofloxacin and tobramycin on POD two when blood cultures grew gram-negative bacilli. On POD three, cultures were identified as Y. enterocolitica and antibiotics were changed to tobramycin and cefotaxime based on susceptibility data. Sequelae of the shock included adult respiratory distress syndrome requiring intubation and a tracheostomy and multiple intracranial hemorrhagic infarcts with subsequent seizure disorder. Due to severe lower extremity ischemia, she required a bilateral below the knee amputation. The cultures of the snippets from the bags of blood transfused to the patient also grew Y. enterocolitica. This case illustrates the importance of considering transfusion related bacterial infections in patients receiving PRBCs. All patients in shock following any type of transfusion may require aggressive antibiotic therapy, until the diagnosis and etiology are known.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
13/135. yersinia enterocolitica sepsis in an adolescent with Cooley's anemia.Human infections due to yersinia enterocolitica have been reported worldwide, predominantly in europe. However, there have been few reports of yersinia enterocolitica infection in taiwan. We report a case of Y. enterocolitica sepsis in a 15-year-old Taiwanese girl with Cooley's anemia and insulin-dependent diabetes mellitus. She presented at admission with fever, shock and consciousness disturbance. She had symptoms of abdominal pain, vomiting and diarrhea for three days before admission. blood pressure stabilized after intravenous normal saline rescue. Blood culture yielded Y. enterocolitica 2 days later and ceftriaxone was administered according to the results of sensitivity tests. She recovered well after a course of antibiotic treatment. Though Y. enterocolitica sepsis is rare in taiwan, clinicians should be aware of its tendency to develop in patients with Cooley's anemia, fever and enterocolitis and that its clinical course may include sepsis leading to shock.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
14/135. Spontaneous pleural empyema due to yersinia enterocolitica.yersinia enterocolitica is a well-known cause of enterocolitis. Although focal extraintestinal manifestations and disseminated disease have been described, usually in immunosuppressed patients, infection in the chest seems to be rare. We report the case of an alcoholic man who had spontaneous pleural empyema due to Y. enterocolitica.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
15/135. HLA-DP restricted chlamydia trachomatis specific synovial fluid T cell clones in Chlamydia induced Reiter's disease.synovial fluid (SF) mononuclear cells from a patient with chlamydia trachomatis induced acute Reiter's disease were directly by limiting dilution in a representative protocol using phytohemagglutinin in the cloning medium. Out of 76 alpha beta-TCR CD4 T lymphocyte clones, 7 were shown to specifically recognize C. trachomatis in a proliferation assay. The antigen recognition of these clones was HLA-DP restricted. Unexpectedly, 2 HLA-DR restricted clones showed a proliferative response to yersinia enterocolitica O3, though the patient had no history of yersinia infection. The high frequency of SF derived T cells with specificity for species-specific chlamydial antigens and the limited diversity of HLA class II restriction of these clones may indicate an oligoclonal synovial T cell response to persistent intraarticular chlamydia.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
16/135. Unusual manifestations of yersinia enterocolitica infections diagnosed using novel methods.We report the cases of two patients who had infections due to yersinia enterocolitica. The first patient exhibited chronic recurrent fever, hepatic and splenic granulomas, and bone marrow abnormalities, and the second patient presented with enterocolitis with leukocytoclastic vasculitis of the skin. Cultures and agglutination titers were negative. Indirect immunofluorescence techniques with use of serotype-specific antisera and antisera to Yersinia outer-membrane proteins (Yops) were applied to biopsy specimens, and immunoblotting techniques for determining class-specific circulating antibodies to Yops were used for demonstrating these unusual manifestations of Y. enterocolitica infections.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
17/135. A palpable right lower abdominal mass due to Yersinia mesenteric lymphadenitis.Infection by yersinia pseudotuberculosis has become of increasing pathological importance. This report describes the case of a 12-year-old female with mesenteric lymphadenitis due to yersinia pseudotuberculosis. The patient presented with fever, abdominal pain, and a palpable right abdominal mass. Abdominal ultrasonic imaging and computerized axial tomography (CT) revealed a mass. An exploratory laparotomy was performed, followed by appendectomy and mesenteric lymph node biopsy. The diagnosis of Yersinia infection was confirmed by serology and bacterial culture of the biopsy material. This condition should be considered in patients with a right lower abdominal mass and symptoms similar to those of appendicitis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
18/135. Yersinia infection mimicking recurrence of gastrointestinal stromal tumor.gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. So far, surgical resection has been the only curative treatment, but new options became available with the application of imatinib (Glivec) as a specific molecular inhibitor. Even after complete resection, GISTs have a high rate of recurrence and disease-linked mortality. Here we report on the case of a clinically well 57-year-old woman who presented to us 3 years after resection of a GIST of the small intestine. Abdominal ultrasound and CT scan showed intestinal wall thickening in the area of anastomosis and mesenteric lymphadenopathy, suggesting a recurrence of the primary GIST. However, serological testing was positive for yersinia antibodies. Surgical exploration revealed an asymptomatic infection with yersinia enterocolitica serotype O9, proven by positive culture and histology, which showed no evidence of malignancy. Prognostic variables for GIST as well as diagnostic measures and limitations for yersiniosis are discussed. In the end, only surgical exploration and histological analysis could establish the final diagnosis. In conclusion, GISTs have a high likelihood of recurrence even after complete resection, but an asymptomatic infection such as yersiniosis must be considered as a differential diagnosis to GIST recurrence.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
19/135. yersinia infections in patients with homozygous beta-thalassemia associated with iron overload and its treatment.patients with homozygous beta-thalassemia are at increased risk of serious infections. yersinia enterocolitica is an organism with a predilection for these and other iron-overloaded patients. Three young adult patients with beta-thalassemia who were chronically transfused and developed yersiniosis are reported. iron overload and desferrioxamine use are predisposing factors, as supported by clinical, animal, and in vitro data. Iron excess both immunologically compromises the host and greatly enhances yersinial growth. Desferrioxamine may make host iron even more bioavailable to Yersinia. Recognition of this association and unusual manifestations in these patients such as an appendicitis-like syndrome may direct clinicians to earlier antiyersinial therapy and temporary cessation of chelation.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
20/135. yersinia enterocolitica intestinal infection with ileum perforation: report of a clinical observation.yersinia enterocolitica infection is responsible in human beings for ileocolitis appearing with abdominal pain, diarrhoea and fever. This kind of disease usually heals spontaneously with no remarkable complication. intestinal perforation is a rare complication of the disease. To date only eleven cases of surgical complications arising from abscess and intestinal perforation due to yersinia enterocolitica have been reported in literature. In our clinical case the patient, who had previously undergone appendicectomy, required urgent surgery for pelvi-peritonitis due to intestinal perforation on necrotic-ulcerative ileitis with adenomesenteritis from yersinia enterocolitica. The surgical treatment combined with intestinal resection and targeted antibiotic therapy have proved to be effective.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
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