[Bacteremia and pneumonia due to Yersinia enterocolitica serotype O:3 in an immunocompetent patient]

COVID-19 presenting as severe, persistent abdominal pain and causing late respiratory compromise in a 33-year-old man

A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew Yersinia enterocolitica. He recovered following supportive management and treatment with piperacillin–tazobactam.

Yersinia enterocoliticaInfection Simulating Lymphoproliferative Disease, after Liver Transplant

We describe a 14-year-old girl, who was 13 y after liver transplantation for biliary atresia with an unremarkable postoperative course. She presented with fever of up to 40°C, extreme fatigue, malaise, anorexia, and occasional vomiting. On physical examination the only finding was splenomegaly. Lab results showed hyperglobulinemia and an elevated sedimentation rate. Liver function tests were normal except for mild elevation ofγGTP. Abdominal U/S and CT demonstrated an enlarged spleen with retroperitoneal and mesenteric lymph nodes enlargement. An exhaustive evaluation for infectious causes, autoimmune conditions, and malignancy was negative. A full recovery after 5 months prompted testing for self-limited infectious etiologies.Yersinia enterocoliticainfection was diagnosed.

Community-acquired pneumonia caused by Yersinia enterocolitica in an immunocompetent patient

Most cases of Yersinia enterocolitica manifest with symptoms of enterocolitis, such as diarrhoea, fever and abdominal pain. Y. enterocolitica is a very rare cause of pneumonia, and usually occurs in immunocompromised patients. We report a case of community-acquired pneumonia (CAP) caused by Y. enterocolitica in an elderly patient who did not develop symptoms of enterocolitis. This aetiology should be considered in patients with CAP who do not respond to initial empirical therapy.

Pneumopathie avec bactériémie à Yersinia enterocolitica chez un patient diabétique porteur de l'antigène HLA-B27

INTRODUCTION

We report a new case of pneumonia and bacteremia due to Yersinia enterocolitica (YE) in a diabetic patient with HLA-B27 positive spondylarthritis.

OBSERVATION

A 75-year-old man was admitted for a pneumonia. He was suffering from HLA-B27 positive spondylarthritis and stable diabetes mellitus. Amoxicillin with clavulanic acid was ineffective. Two blood and stool cultures were positive for YE. There was no evidence of septic metastases, immunodepression and iron overload. Outcome was uneventful after 21 days of ofloxacin.

CONCLUSION

YE pneumonia is rare. In this patient, diabetes mellitus and spondylarthritis with HLA-B27 may have played a role in the infection but their imputability remain questionable.