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Invasive Yersiniosis in a Pediatric Patient With β-Thalassemia Major

Acute Decompensation After Rapid Blood Transfusion

Hsu, George MD, MS; Jones, Andrew BS, BA; Thornton, Ben BS, BA

doi: 10.1097/PEC.0000000000001873
Illustrative Cases
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Yersinia enterocolitica infection, or yersiniosis, is a common cause of gastroenteritis in developing nations, but the disease is less common in the developed world. Yersiniosis typically presents as a self-limited gastroenteritis in an immunocompetent patient and rarely progresses to the more fulminant disseminated form. Certain patient populations are at greater risk of disseminated disease, and providers caring for these patients should have heightened suspicion for invasive disease. Patients dependent on serial transfusion therapy, such as those with inherited hemoglobinopathies, often have chronically elevated serum iron levels. These patients are at increased risk of fulminant yersiniosis due to the bacteria's siderophilic nature. Yersinia infection can be devastating in these patients, and early intervention with empiric antibiotics combined with targeted resuscitation can be essential in their care. The following case illustrates the utility for heightened surveillance, early intervention, and guided resuscitation in the management of this at-risk population.

From the Department of Emergency Medicine, Augusta University, Augusta, GA.

Disclosure: The authors declare no conflict of interest.

Reprints: George Hsu, MD, MS, Augusta University Health Sciences Campus AF-1018. Augusta, GA 30912 (e-mail: ghsu@gru.edu).

Online date: June 18, 2019

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