{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:17Z","timestamp":1756339337042,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"7","funder":[{"name":"SAUSHEC Internal Medicine","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,10]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>\n                  <jats:italic>Yersinia enterocolitica<\/jats:italic> 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 <jats:italic>Y.<\/jats:italic>\u202f<jats:italic>enterocolitica<\/jats:italic> 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 <jats:italic>Y.\u202fenterocolitica<\/jats:italic>. Ultimately, he improved with supportive care. This case highlights the importance of thorough workup of terminal ileitis and \u2018Crohn\u2019s mimics\u2019 which ultimately revealed a unifying diagnosis; and an important addition to the workup for undifferentiated severe isolated hepatocellular liver injury.<\/jats:p>","DOI":"10.1136\/bcr-2021-242369","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T12:22:04Z","timestamp":1625574124000},"page":"e242369","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Severe acute liver injury associated with <i>Yersinia enterocolitica<\/i>"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8714-7758","authenticated-orcid":false,"given":"Jessica","family":"Demes","sequence":"first","affiliation":[{"name":"Internal Medicine, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6058-8019","authenticated-orcid":false,"given":"Carl","family":"Kay","sequence":"additional","affiliation":[{"name":"Internal Medicine, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amilcar","family":"Morales-Cardona","sequence":"additional","affiliation":[{"name":"Gastroenterology, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stalin","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Gastroenterology, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,6]]},"reference":[{"key":"2025082622554456000_14.7.e242369.1","first-page":"118","article-title":"Mesenteric lymphadenitis caused by Yersinia enterocolitica","volume":"10","author":"Zi\u0144czuk","year":"2015","journal-title":"Prz Gastroenterol"},{"key":"2025082622554456000_14.7.e242369.2","doi-asserted-by":"crossref","unstructured":"Galindo CL , Rosenzweig JA , Kirtley ML . Pathogenesis of Y. enterocolitica and Y. pseudotuberculosis in Human Yersiniosis. J Pathog 2011;182051.doi:10.4061\/2011\/182051","DOI":"10.4061\/2011\/182051"},{"key":"2025082622554456000_14.7.e242369.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-010-0112-5"},{"key":"2025082622554456000_14.7.e242369.4","unstructured":"LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Doxycycline. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548353\/ [Accessed Updated 23 Jan 2019]."},{"key":"2025082622554456000_14.7.e242369.5","doi-asserted-by":"publisher","DOI":"10.1177\/104063871102300233"},{"key":"2025082622554456000_14.7.e242369.6","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/166.4.812"},{"key":"2025082622554456000_14.7.e242369.7","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/j.1365-2796.1992.tb00969.x","article-title":"Acute and chronic liver disease associated with Yersinia enterocolitica infection: a Norwegian 10-year follow-up study of 458 hospitalized patients","volume":"231","author":"Saeb\u00f8","year":"1992","journal-title":"J Intern Med"},{"key":"2025082622554456000_14.7.e242369.8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1056\/NEJM198907063210104","article-title":"Yersinia enterocolitica","volume":"321","author":"Cover","year":"1989","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025082622554456000_14.7.e242369.9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1080\/17843286.1994.11718368","article-title":"Yersiniosis: the clinical spectrum","volume":"49","author":"Baert","year":"1994","journal-title":"Acta Clin Belg"},{"key":"2025082622554456000_14.7.e242369.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2011.07.017"},{"key":"2025082622554456000_14.7.e242369.11","first-page":"271","article-title":"Terminal ileitis is not always Crohn's disease","volume":"24","author":"Bojic","year":"2011","journal-title":"Ann Gastroenterol"},{"key":"2025082622554456000_14.7.e242369.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2007.04.007"},{"key":"2025082622554456000_14.7.e242369.13","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-218185"},{"key":"2025082622554456000_14.7.e242369.14","doi-asserted-by":"crossref","first-page":"773","DOI":"10.2214\/ajr.157.4.1892033","article-title":"Systemic Yersinia enterocolitica infection associated with iron overload and deferoxamine therapy","volume":"157","author":"Abcarian","year":"1991","journal-title":"AJR Am J Roentgenol"},{"key":"2025082622554456000_14.7.e242369.15","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.517"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-242369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:55:54Z","timestamp":1756274154000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-242369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,6]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-242369"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-242369","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}