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Spontaneous Yersinia enterocolitica septicemia in a patient with iron overload

S S Larigakis1, M A Noble, T G Sparling

  • 1University Hospital and the University of British Columbia, Vancouver, British Columbia.

The Canadian Journal of Infectious Diseases = Journal Canadien Des Maladies Infectieuses
|May 4, 2012
PubMed

Insights

Patients with iron overload, like those with myelodysplastic syndrome, are at risk for Yersinia enterocolitica sepsis. This study highlights both host and microbial factors contributing to this serious infection.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Microbiology

Background:

  • Yersinia enterocolitica can cause sepsis, particularly in immunocompromised individuals.
  • Transfusional iron overload is a condition that may compromise host defenses.
  • Myelodysplastic syndromes are a group of disorders characterized by ineffective blood cell production.

Purpose of the Study:

  • To describe a case of Yersinia enterocolitica septicemia in a patient with transfusional iron overload and myelodysplastic syndrome.
  • To identify host and microbial factors contributing to the development of sepsis in this patient.
  • To emphasize the susceptibility of patients with iron overload to Yersinia enterocolitica infections.

Main Methods:

  • Case report detailing a patient's clinical presentation and laboratory findings.
  • Microbiological characterization of the Yersinia enterocolitica isolate, including biotyping, serotyping, and plasmid analysis.
  • Assessment of microbial virulence factors such as calcium dependence and autoagglutination.
  • Evaluation of host immune function, specifically neutrophil chemotaxis and bactericidal activity.
  • Animal model (mice) used to assess bacterial virulence via oral challenge.

Main Results:

  • The patient presented with Yersinia enterocolitica septicemia.
  • The isolated organism was biotype 1, serotype 0:5,27, possessing a virulence plasmid.
  • The Yersinia strain exhibited calcium-dependent growth, autoagglutination, and virulence in mice but lacked serum resistance.
  • The patient demonstrated impaired neutrophil chemotaxis and bactericidal activity.
  • Both patient-specific factors (iron overload, myelodysplastic syndrome, immune dysfunction) and bacterial factors (virulence plasmid) were implicated.

Conclusions:

  • Patients with transfusional iron overload, particularly those with underlying conditions like myelodysplastic syndrome, are compromised hosts.
  • These individuals are susceptible to spontaneous sepsis caused by Yersinia enterocolitica.
  • Recognition of iron overload as a risk factor for Yersinia sepsis is crucial for clinical management and prevention.
Keywords:
IronSepticemiaYersinia

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