Yokenella regensburgei of the family Enterobacteriaceae is a rare clinical isolate. Only six infection cases in humans have been reported previous to the present. We report a case of infectious diarrhea with sepsis symptoms in a 17 year old patient with Y. regensburgei.difference being that H. alvei is resistant to colistin and VogesProskauer Test (VP) negative, whereas Y. regensburgei has the opposite characteristics [8,9]. The National Institutes of Health in Japan identified Y. regensburgei as NIH biogroup 9 and the Centers for Disease Control and Prevention in Atlanta as enteric group 45, proposing the name Koserella trabulsii. The name Yokenella regensburgei proposed by Kosako et al. [1] finally prevailed over K. trabulsii [1,2]. The bacterium has been isolated from intestinal tracks of insects and reptiles, well water and salad [7] as well as from the following human anatomical sites: blood [6], faecal samples [8], upper respiratory tract, urine [2,3] and knee fluid [9,10]. The small number of the cases reported with Y.regensburgei as a pathogen is responsible for the shortage of epidemiological and clinical information. Here we present a case from Y.regensburgei which is to our current knowledge the first case reported in Greece.
Case ReportA 17-year old male athlete was transported to General Hospital of Messolonghi from the community Health Centre of Astakos with 6-7 daily episodes of diarrhea, fever up to 39.8 o C and chills. The patient reported that these smptoms emerged three days before his arrival to the Health Centre of Astakos, three hours after physical exercise and that the fever would not subside with the consumption of paracetamol and mefenamic acid. He arrived to General Hospital of Messolonghi on the fourth day of the symptoms. Physical examination with deep palpation of abdomen showed sensitivity in the entire abdominal wall and increased bowel sounds. A systemic examination revealed nothing of note. Patient's medical history showed only cefuroxime allergy. His vital signs were: blood pressure 135/60 mm/Hg, pulse rate 105/ min, Oxygen Saturation (SO2) 98% and body temperature 39.0°C. Upper and lower abdominal sonography results were normal. Laboratory examination showed leukocytosis (WBC 13, ), neutrophilia (76.7%, normal range 40-74%), absolute neutrophil count 10,180/mml -3 , lymphocytes 11.8% (19-48%), monocytes 7% (3.4-9%), eosinophils 1.5% (0-7%), increased CReactive Protein (CRP) 18.76 mg/dl (0-0.8mg/dl), hemoglobin 14,2 mg dl -1 and mean corpuscular volume (MCV) 78,5fL. The rest of the biochemical test results (glucose, urea, creatinine, uric acid, bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transainase (SGPT), alkaline phosphatase, gamma-glutamyl transferase (G-GT), amylase, albumin, total serum protein, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), Calcium (Ca), Sodium (Na), Potassium (K) , total cholesterol (TC), high-density lipoprotein, low-density lipoprotein, Iron (Fe), immunoglobulin igG, igM and IgA) were normal. ...