Systematic Yersinia enterocolitica in an iron overloaded and immunocompromised thalassemic patient

We report the case of a 43-year-old woman who presented with lower abdominal pain, maculopapular rash, arthritis of the left knee and left ankle joints, with a history of thalassemia and heavy iron overload. She was also on haemodialysis therapy three times a week for end stage renal therapy. Yersinia enterocolitica and Yersinia pseudotuberculosis cause yersiniosis, a diarrhoeal illness. Members of the genus Yersinia are gram-negative coccobacilli; they are facultative anaerobes in the family Enterobacteriaceae. Serological examinations revealed positive IgA and IgG antibodies against Yersinia enterocolitica outer membrane proteins (Yops) for YopD(4a) and Yop M(2a) and IgG for LorV (V antigen). Enteritis an reactive arthritis presented as the primary manifestation of Y. enterocolitica infection. Important risk factors include iron overload, cirrhosis, and immune suppression. The patient was successfully treated with oral ciprofloxacin.