Zapata R, García P
Departamentos de Gastroenterología, Universidad Católica de Chile, Santiago de Chile.
Rev Med Chil. 1997 Aug;125(8):917-21.
Yersinia enterocolitica is a gram-negative bacillus that thrives in conditions associated with iron overload. We describe an unusual case of a diabetic patient with a previously unrecognized hemochromatosis presenting with Y. enterocolitica septicemia. He was admitted because of a 10 day history of abdominal pain, fever and jaundice. Blood cultures grew Y. enterocolitica. The abdomen CT scan showed multiple liver and splenic abscesses. Antibiotic treatment with ciprofloxacin (2 months) resulted in a good clinical response. Serum iron studies showed iron overload. Liver biopsy revealed moderate fibrosis and early cirrhosis with large amounts of hemosiderin granules deposited in hepatocytes and bile duct epithelium. This report reviews the literature and highlights that iron overload must be ruled out in Yersinia septicemia patients.
小肠结肠炎耶尔森菌是一种革兰氏阴性杆菌,在与铁过载相关的条件下生长旺盛。我们描述了一例不寻常的病例,一名患有先前未被识别的血色素沉着症的糖尿病患者出现小肠结肠炎耶尔森菌败血症。他因持续10天的腹痛、发热和黄疸病史入院。血培养结果显示为小肠结肠炎耶尔森菌。腹部CT扫描显示肝脏和脾脏有多个脓肿。使用环丙沙星进行抗生素治疗(2个月)取得了良好的临床效果。血清铁研究显示存在铁过载。肝脏活检显示中度纤维化和早期肝硬化,肝细胞和胆管上皮中有大量含铁血黄素颗粒沉积。本报告回顾了相关文献,并强调在耶尔森菌败血症患者中必须排除铁过载。