Yersinia pseudotuberculosis Bacteremia with Splenic Abscesses: A Case Report

Yersinia pseudotuberculosis is a gram-negative bacillus from the family of Yersiniacae. Similar to the other member of the family, Yersinia enterocolitica, Y. pseudotuberculosis most commonly presents with enteric illness [1]. The sources of infection with Y. pseudotuberculosis include contaminated food such as dairy and vegetables or contaminated water [2].  Direct contact with animals including dogs, rodents, rabbits, farm animals or birds has also been described as other modes of acquisition [1,2]. Community outbreaks secondary to contaminated lettuce, carrots, and water have been reported in Finland, Japan, Russia and Canada [3,4]. Although it often presents as mild gastroenteritis, several other clinical manifestations have been reported with Y. pseudotuberculosis [1]. Pseudoappendicitis with mesenteric lymphadenitis is a well described phenomenon and many patients in the 20th century underwent appendectomies due to erroneous diagnosis after presenting with right lower quadrant abdominal pain [5]. Bacteremia is rare and when it occurs it has been associated with abscesses in spleen, liver, kidneys, lung with granulomatous appearance that mimics tuberculosis [5,6]. Although it is commonly a self-limiting illness in immunocompetent patients without liver disease, septicemia with Y. pseudotuberculosis is thought to carry a fatality rate that exceeds 75% without antibiotics [2]. Here we present a case of Yersinia pseudotuberculosis bacteremia with splenic abscesses in a patient with previously undiagnosed liver cirrhosis.