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June 19, 1987

Yersinia Hepatic Abscesses and Iron Overload

JAMA. 1987;257(23):3230-3231. doi:10.1001/jama.1987.03390230066023

To the Editor.—  Leighton and MacSween1 describe the occurrence of septicemia and multiple abscesses due to Yersinia enterocolitica in a patient who had been receiving long-term iron therapy. Their report is further evidence of the remarkable susceptibility of patients with high iron stores to generalized Y enterocolitica infection.From 1978 to 1986, in Italy, almost all cases of severe clinical disease due to Y enterocolitica developed in subjects with iron overload. In fact, eight of ten cases of Y enterocolitica septicemia occurred in patients with β-thalassemia major, while Y enterocolitica peritonitis was encountered in these patients exclusively.2,3 All isolates belonged to human pathogenic strains (Y enterocolitica biogroup 4, serogroup 03, phage type VIII; biogroup 2, serogroup 09, phage type X3). Five patients presented with deep suppuration limited to sites in the digestive system, such as the appendix and the mesenteric lymph nodes.It has been suggested that