Abstract
While Campylobacter jejuni represents the most common cause of bacterial gastroenteritis, Yersinia pseudotuberculosis infections are very rarely diagnosed in adults. We report on a previously healthy patient who presented several times at our hospital with fever, Guillain-Barré syndrome, recurrent abdominal symptoms and distinct mesenteric lymphadenopathy, respectively. This complicated and diagnostically challenging course of disease was caused by a C. jejuni and Y. pseudotuberculosis coinfection. Antibiotic treatment with doxycycline was effective. Broad serology testing was crucial to discover that two concomitant infections were causing the symptoms. This case demonstrates that when a clinical picture is not fully explained by one known infection, another infection with the same underlying risk factor has to be considered, hence "a horse and a zebra".
References
Jul 1, 1991·Clinical Microbiology Reviews·R R Brubaker
Mar 7, 1987·Lancet·S E AttwoodF B Keane
Feb 1, 1984·The Journal of Infectious Diseases·R TerttiA Toivanen
Nov 23, 1995·The New England Journal of Medicine·J H ReesR A Hughes
Dec 13, 1997·The Journal of Infectious Diseases·M J Blaser
Sep 28, 2001·Journal of Clinical Microbiology·H FukushimaX B Zheng
Jul 23, 2003·Infection and Immunity·Lauren K Logsdon, Joan Mecsas
Feb 21, 2004·The Journal of Infectious Diseases·Robert V Tauxe
Feb 21, 2004·The Journal of Infectious Diseases·J Pekka NuortiPetri Ruutu
Oct 14, 2008·Anaerobe·S M HorrocksS C Ricke
Mar 6, 2010·Emerging Infectious Diseases·Cherie LongL Hannah Gould
May 18, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Magdalena E KendallBarbara E Mahon
Feb 14, 2013·Deutsche medizinische Wochenschrift·A M HauriJ Krahn
Oct 12, 2013·Journal of Food Protection·C NathuesR Merle
Jun 13, 2015·Clinical Microbiology Reviews·Nadeem O KaakoushSi Ming Man
May 31, 2018·Infection·Eric NulensAstrid Muyldermans
Nov 18, 2018·Tropical Medicine & International Health : TM & IH·Virginia Kagure WachiraMaria Regina Fernandes de Oliveira