Wang Yixun, Xiang Yanni, Lei Chao, Zheng Xiaxia, Wu Wen, Zhang ZhaoHui, Qu Xingguang
The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei Province, 443000, China.
Department of Intensive Medicine, Yichang Central People's Hospital, Yichang, Hubei Province, 43000, China.
BMC Infect Dis. 2024 Dec 18;24(1):1415. doi: 10.1186/s12879-024-10325-z.
Yersinia pseudotuberculosis is an emerging zoonotic intestinal pathogen primarily transmitted through contaminated food and water. Infections caused by Yersinia pseudotuberculosis are typically self-limiting, often presenting as gastroenteritis or "pseudoappendicitis," which is characterized by fever and abdominal pain. Although bloodstream infections with Yersinia pseudotuberculosis are rare, they can lead to multiple distant sites of infection, including abscesses in the liver, spleen, and kidneys, as well as in the hip and knee joints, particularly in individuals with underlying immunodeficiency.
We report the case of a 40-year-old male patient who was admitted to the intensive care unit (ICU) with intermittent fever lasting for five days, followed by exacerbation of abdominal pain and distension one day after ingesting contaminated food. Upon admission, the patient exhibited severe hypotension, which rapidly progressed to signs of liver and kidney failure, ultimately leading to multiple organ dysfunction syndrome (MODS). Notably, abdominal computed tomography (CT) revealed evidence of a liver abscess and splenic infarction. The treatment regimen included fluid resuscitation, broad-spectrum antibiotics, vasopressors, continuous renal replacement therapy (CRRT), and plasma exchange. Blood cultures along with metagenomic next-generation sequencing (mNGS) confirmed an infection caused by Yersinia pseudotuberculosis. After 17 days in the ICU, the patient was transferred to the infectious disease department for an additional 14 days of treatment before being discharged. Three months post-discharge, follow-up visits indicated that the patient was in good health.
To the best of our knowledge, this case represents a rare instance of multiple organ dysfunction syndrome (MODS), liver abscess, and splenic infarction resulting from Yersinia pseudotuberculosis infection. The identification of the pathogen was facilitated by blood culture and metagenomic next-generation sequencing (mNGS) of blood samples. The administration of broad-spectrum antibiotics, along with active support for organ function, ultimately contributed to the patient's recovery.
No applicable.
假结核耶尔森菌是一种新出现的人畜共患肠道病原体，主要通过受污染的食物和水传播。假结核耶尔森菌引起的感染通常为自限性，常表现为胃肠炎或“假阑尾炎”，其特征为发热和腹痛。虽然假结核耶尔森菌引起的血流感染很少见，但可导致多个远处感染部位，包括肝脏、脾脏和肾脏的脓肿，以及髋关节和膝关节的脓肿，尤其是在有潜在免疫缺陷的个体中。
我们报告一例40岁男性患者，因持续5天的间歇性发热入院重症监护病房（ICU），在摄入受污染食物一天后腹痛和腹胀加剧。入院时，患者表现出严重低血压，迅速发展为肝肾功能衰竭迹象，最终导致多器官功能障碍综合征（MODS）。值得注意的是，腹部计算机断层扫描（CT）显示有肝脓肿和脾梗死迹象。治疗方案包括液体复苏、广谱抗生素、血管加压药、持续肾脏替代治疗（CRRT）和血浆置换。血培养以及宏基因组下一代测序（mNGS）证实为假结核耶尔森菌感染。在ICU治疗17天后，患者转至感染科继续治疗14天，然后出院。出院后三个月的随访显示患者健康状况良好。
据我们所知，该病例是假结核耶尔森菌感染导致多器官功能障碍综合征（MODS）、肝脓肿和脾梗死的罕见病例。血培养和血样宏基因组下一代测序（mNGS）有助于病原体的鉴定。广谱抗生素的使用以及对器官功能的积极支持最终促成了患者的康复。
不适用。
