Abstract
Yersinia pseudotuberculosis is a Gram-negative bacterium of the family Yersiniaceae, primarily transmitted via the gastrointestinal tract. Progression to sepsis is uncommon, and the combination of septic shock and splenic infarction is exceedingly rare. We report a 40-year-old male who initially presented with fever, abdominal pain, and distension, which rapidly progressed to sepsis and multi-organ dysfunction. Definitive diagnosis of Y. pseudotuberculosis infection was established by blood culture and metagenomic next-generation sequencing, supported by imaging evidence of splenic infarction. The patient was managed with stepwise antimicrobial regimens (including piperacillin-tazobactam, meropenem, levofloxacin, linezolid, and daptomycin), plasma exchange, continuous renal replacement therapy, and organ function support. Following comprehensive treatment, the patient recovered and was discharged in stable condition. This case highlights the importance of considering Y. pseudotuberculosis in atypical sepsis presentations and demonstrates that timely diagnosis and multidisciplinary management are crucial to improving outcomes in such rare and life-threatening infections.