Yersinia pseudotuberculosis infection with severe localised inflammation and ulceration of the ileum in a heart transplant patient

In this case, we present an uncommon gastrointestinal
infection in an immunocompromised patient that was
solely diagnosed because of close collaboration between
treating physicians and microbiologists. The patient is a
42-year-
old
male who underwent heart transplantation
5 years earlier. He presented with fever, weight loss,
diarrhoea and tiredness. Initial investigations could not
elucidate the aetiology of his symptoms. The patient
was referred to the department of infectious diseases
for further evaluation. Serology for Yersinia species was
ordered and the result was suggestive for the possibility
of a Yersinia species infection. Close collaboration
between treating physicians and microbiologists followed
and led to additional investigations, which revealed the
diagnosis of a Yersinia pseudotuberculosis infection with
extensive lesions in the gastrointestinal tract. Treatment
with ciprofloxacin resulted in complete resolution of
symptoms and healing of the gastrointestinal lesions.
In conclusion, this case underlines the need for a
multidisciplinary approach to complex patients of which
symptoms have yet to be understood