Chirio R, Collignon A, Sabbah L, Lestradet H, Torlotin J C
Ann Pediatr (Paris). 1989 May;36(5):308; 311-4.
We report two cases of severe Yersinia enterocolitica infection in children with homozygous thalassemia. One patient had septicemia and the other had mesenteric adenitis. Two factors can enhance the infectivity of Yersinia enterocolitica in children with thalassemia: iron overload and deferoxamine therapy. Laparotomy and cefotaxime-netilmicin therapy were successful in the patient with mesenteric adenitis. In the patient with septicemia, cefotaxime-netilmicin, then doxycycline-netilmicin failed, and recovery was finally achieved under rifampicin-netilmicin. Because of the possibility of septicemic dissemination secondary to digestive Yersinia enterocolitica infection in children with thalassemia, we advocate immediate discontinuation of deferoxamine and prescription of oral antimicrobial therapy (trimethoprim-sulfamethoxazole for instance) in every thalassemic patient with febrile diarrhea.
我们报告了两例纯合子型地中海贫血儿童严重小肠结肠炎耶尔森菌感染病例。一名患者发生败血症，另一名患者患有肠系膜腺炎。有两个因素可增强地中海贫血儿童小肠结肠炎耶尔森菌的感染性：铁过载和去铁胺治疗。剖腹手术及头孢噻肟-奈替米星治疗对肠系膜腺炎患者有效。败血症患者接受头孢噻肟-奈替米星治疗，然后多西环素-奈替米星治疗失败，最终在利福平-奈替米星治疗下康复。鉴于地中海贫血儿童因消化性小肠结肠炎耶尔森菌感染继发败血症播散的可能性，我们主张对每例发热腹泻的地中海贫血患者立即停用去铁胺并给予口服抗菌治疗（例如甲氧苄啶-磺胺甲恶唑）。
