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Severe acute liver injury associated with Yersinia enterocolitica
  1. Jessica Demes1,
  2. Carl Kay1,
  3. Amilcar Morales-Cardona2 and
  4. Stalin Subramanian2
  1. 1Internal Medicine, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA
  2. 2Gastroenterology, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA
  1. Correspondence to Dr Jessica Demes;{at}


Yersinia enterocolitica is a Gram-negative bacterium that causes foodborne illnesses, typically characterised by acute febrile gastroenteritis and is associated with a variety of manifestations. Isolated febrile illness without gastrointestinal symptoms is rare. We report a case of Y.enterocolitica infection with severe anicteric hepatitis. A 33-year-old Chinese man with no significant medical history presented on multiple occasions to the emergency department with recurrent high-grade fever and chills, but without gastrointestinal symptoms. Hepatic panel showed rising transaminases that peaked at Aspartate Aminotransferase (AST) of 991 U/L and Alanine Aminotransferase (ALT) of 1664 U/L. CT of the abdomen revealed terminal ileitis and mesenteric adenitis. As part of workup, we found positive serology for Y. enterocolitica. Ultimately, he improved with supportive care. This case highlights the importance of thorough workup of terminal ileitis and ‘Crohn’s mimics’ which ultimately revealed a unifying diagnosis; and an important addition to the workup for undifferentiated severe isolated hepatocellular liver injury.

  • gastrointestinal system
  • infection (gastroenterology)
  • liver disease
  • hepatitis other

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  • Contributors JD and CK drafted the case report. CK was involved in the care of the patient described under the supervision of Drs AM-C and SS. Final approval of the drafted case report went through AM-C and SS.

  • Disclaimer ‘The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, and the Department of Defense or the US Government.’ ‘The voluntary, fully informed consent of the subjects used in this research was obtained as required by 32 CFR 219 and DODI 3216.02_AFI 40-402.’

  • Competing interests None declared.

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