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Yersinia pseudotuberculosis infection with severe localised inflammation and ulceration of the ileum in a heart transplant patient
  1. Maarten Heuvelmans1,
  2. Marieke H A Lammertink2,
  3. Johannes G Kusters1,
  4. Anke H W Bruns3 and
  5. Jan F Monkelbaan2
  1. 1Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
  2. 2Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands
  3. 3Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Maarten Heuvelmans; maartenheuvelmans1990{at}


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.

  • foodborne infections
  • endoscopy
  • infection (gastroenterology)

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  • Contributors MH has written the draft of the manuscript. ML has advised and written the draft of the case description. JM has consulted in making the final version of the manuscript. JK has specifically advised on writing the parts about testing and AB had supervised the diagnostic workup from an internal medicine point of view.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.