Two Cases of Mesenteric Lymph Node Abscess due to Yersinia Enterocolitica

Akemi Yoshikawa, Yasuyuki Seto, Kaori Hayashi, Yuichi Tanaka, Rikkou Lee, Takao Hanaoka, Taiji Seto, Toshifumi Suzuki^*, Youko Akabane^* and Iwao Ono^**

Department of Surgery, Radiology^* and Pathology^**, Nakadori General Hospital

We report 2 successive cases of mesenteric lymph node abscess formation following enterocolitis and mesenteric lymphadenitis of the ileocecal region which required surgical treatment. Case1 is a 70-year-old woman with chronic pancreatitis and diabetes mellitus who complained of a right lower quadrant pain and a fever. Case2 is a 73-year-old man with liver cirrhosis (HCV infection), diabetes mellitus, and hypertension who complained of a right lower quadrant pain. Both patients were elderly and with predisposing underlying disease. Yersinia enterocolitica (Y. ent) was isolated from pus in both cases. Y. ent occurs most commonly as self-limiting enterocolitis in young children, but may sometimes cause pseudoappendicular ileocecal enterocolitis and mesenteric lymphadenitis in adults. Mesenteric lymphadenitis in general rarely form abscesses. However, Y. ent may cause sepsis and extraintestinal abscesses on rare occasions depending on the virulence of the pathogen and the physical status of the host. Abscesses can form following mesenteric lymphadenitis, and may require surgical intervention. Potent antimicrobial therapy and close follow-up are mandatory.

Key words
enterocolitis, suppurative mesenteric lymphadenitis, Yersinia enterocolitica

Reprint requests
Akemi Yoshikawa Department of Surgery, Nakadori General Hospital 3-15 Misono-cho, Minami-dori, Akita, 010-8577 JAPAN

Accepted
March 26, 2003

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