Cases reported "Yersinia Infections"

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11/218. intussusception due to yersinia enterocolitica enterocolitis in a patient with beta-thalassemia.

    patients who are homozygous for thalassemia major are at risk for yersinia enterocolitica infections. We present a case of a 4-year-old child with intussusception of the terminal ileum whose past medical history was significant for beta-thalassemia. His monthly blood transfusions for this condition may have put him at risk for Y enterocolitica enterocolitis. The pathogenesis of this disease relates to the role of iron as an essential growth factor for Yersinia, and this patient's transfusions left him in an iron-overloaded state, despite treatment with Desferal. Our patient's unusual presentation of intussusception was secondary to the mass effect caused by lymphoid hyperplasia, specifically hypertrophied peyer's patches in the ileum caused by Y enterocolitica infection. To our knowledge, this is the first such case of intussusception caused by Yersinia to be reported. ( info)

12/218. Transfusion-mediated yersinia enterocolitica septicemia in an adult patient with beta-thalassemia.

    We report a case of transfusion-mediated yersinia enterocolitica septicemia in a 43-y-old woman with homozygous beta-thalassemia. Two h after transfusion of 3 units of red blood cells the patient suffered high-grade fever and shaking chills. Y. enterocolitica serotype O3 grew in blood cultures. Prolonged treatment with i.v. ceftriaxone plus ciprofloxacin led to a favorable outcome. Transfusion-associated Y. enterocolitica septicemia has not previously been reported in an adult beta-thalassemic patient from the Mediterranean area. Our report is particularly important, because of the high incidence of chronically transfused thalassemic patients in Mediterranean countries. ( info)

13/218. Infectious endocarditis due to yersinia enterocolitica.

    yersinia enterocolitica is a gram-negative coccobacillus. Y. enterocolitica infection is acquired by humans via the oral route. Infection due to Y. enterocolitica was first observed in 1933 in new york. Y. enterocolitica septicemia has been increasingly recognized in recent years, whereas endocarditis due to Y. enterocolitica is a rare manifestation. We herein describe a patient who developed Y. enterocolitica endocarditis and was successfully treated with a combination of drugs consisting of a quinolone (ofloxacin) and an aminoglycoside (netilmicin). ( info)

14/218. 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. ( info)

15/218. 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. ( info)

16/218. 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. ( info)

17/218. 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. ( info)

18/218. MHC-unrestricted recognition of bacteria-infected target cells by human CD8 cytotoxic T lymphocytes.

    A CD8 alpha beta TCR T cell clone (A35) was isolated from the synovial fluid of a patient with post-enteric reactive arthritis caused by yersinia enterocolitica. This clone efficiently killed autologous and allogeneic target cells that had been preincubated with live but not with heat-killed bacteria. There was no restriction by polymorphic parts of HLA-A, -B, or -C molecules and a HLA class II-deficient mutant cell line was lysed as efficiently as its normal counterpart, whereas infected HLA class I-deficient cells (Daudi cells) were not. The clone showed crossreaction between yersinia enterocolitica, escherichia coli, pseudomonas aeruginosa, and streptococcus pyogenes, but did not lyse target cells preincubated with staphylococcus epidermidis. MAb to CD2, CD3, and CD8 efficiently blocked A35, whereas the addition of mAb to HLA class II or to HLA class I did not. This clone apparently represents a novel effector mechanism against bacteria-infected or -modified cells that could be involved in the immunopathology of reactive arthritis. ( info)

19/218. 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. ( info)

20/218. 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. ( info)
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