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Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

Journal

BMC INFECTIOUS DISEASES
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12879-020-05733-w

Keywords

Azithromycin; Bacteremia; Cefmetazole; Ceftriaxone; Doripenem; Septic shock; Yersinia pseudotuberculosis

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This case study describes a case of septic shock caused by Yersinia pseudotuberculosis infection in an immunocompetent patient. Appropriate microorganism tests and antibiotic therapy are essential for successful treatment of Y. pseudotuberculosis bacteremia.
Background: Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation: A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14days. He recovered without relapse. Conclusions: We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

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