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Yersinia Enterocolitica Infection

Yersinia enterocolitica infection is a disease which could be seen all over the world. Pigs are described as the main reservoirs of the responsible microorganism, and the consumption of raw, undercooked pork is the primary mode of infection. Gastroenteritis is the main way of presentation with reported manifestations of watery or bloody diarrhea, vomiting, tenesmus, abdominal pain, and fever. A presumptive diagnosis rests on identifying recent consumption of suspicious food, whereas microbiological studies, as well as serologic and molecular methods, are used for the confirmation.


Presentation

Yersinia enterocolitica, a Gram-negative coccobacillus, is an important pathogen [1] [2]. This bacterial microorganism causes infections all over the world, both sporadically and in the form of outbreaks [1] [2] [3]. Pigs are established as the main reservoir of Yersinia enterocolitica and unprocessed, raw, or undercooked pork meat are regarded as the primary source of infection, while contaminated water sources are also described in the pathogenesis [1] [2] [4] [5] [6]. Furthermore, cattle, goats, sheep, wild boars, cats, dogs, and small rodents are also identified as reservoirs of Yersinia enterocolitica [7]. Several outbreaks were attributed to the consumption of contaminated dairy products and tofu cheese [1] [6]. Gastroenteritis is the hallmark of Yersinia enterocolitica infection and is primarily encountered in infants and children under 10 years of age [1] [2] [3] [6] [8]. The spectrum of manifestations ranges from a benign and self-limiting abdominal discomfort to severe right lower quadrant abdominal pain (often mimicking appendicitis), tenesmus, vomiting, fever, and watery or bloody diarrhea [2] [3] [6] [7] [8] [9]. The symptoms are typically present for 7-14 days, but complications of Yersinia enterocolitica infection may be glomerulonephritis, myocarditis, reactive arthritis, and erythema nodosum [3] [6], whereas sepsis and extraintestinal dissemination of the infection are seen in rare cases [2] [3]. The presence of cirrhosis, malignancies, diabetes mellitus, and iron overload is associated with an increased risk for a systemic infection [2] [3] [8].

Fever
  • The patient was a five-year-old girl from a poor Muslim family, and admitted to ICDDR,B's Treatment Centre with complaints of abdominal pain, low-grade fever and diarrhoea.[ncbi.nlm.nih.gov]
  • The patient was a 34-year-old Indian woman who had a four day history of fever, abdominal pain and cough and loose stools for 2 days. She was diagnosed and treated as a case, initially of bacillary dysentery, and then of urban typhus.[ncbi.nlm.nih.gov]
  • Abstract Diarrhea, moderate to high fever and pain in the RLQ associated with a tender mass or swelling of the terminal ileum arouse suspicion of acute terminal ileitis.[ncbi.nlm.nih.gov]
  • Author information 1 Department of Dermatology, St Luke's International Hospital, Chuo-ku, Tokyo, Japan. [email protected] Abstract We report a 74-year-old woman who presented to hospital with fever, vomiting, diarrhea, and 2 weeks later developed[ncbi.nlm.nih.gov]
  • Gastroenteritis is the main way of presentation with reported manifestations of watery or bloody diarrhea, vomiting, tenesmus, abdominal pain, and fever.[symptoma.com]
Reiter's Syndrome
Malaise
  • She also reported subjective undocumented fever, diffuse myalgias, and malaise. She had experienced no symptomatic relief from standard dosing of over-thecounter ibuprofen q6h prn for three days.[omicsonline.org]
Diarrhea
  • RESULTS: Patients with diarrhea were younger than those without diarrhea (P 0.014). Older children had abdominal pain or irritability more frequently than younger children (P 0.004).[ncbi.nlm.nih.gov]
  • At first admission, 184 patients had abdominal pain; 200, diarrhea; 45, vomiting; and 36, weight loss. Ulcerative colitis was diagnosed in 7 patients, Crohn's disease in 2, and unspecific colitis in 11.[ncbi.nlm.nih.gov]
  • Abstract A 69-year-old woman with a 5-wk history of diarrhea and abdominal pain was found to have multiple perforations of the terminal ileum.[ncbi.nlm.nih.gov]
  • Abstract Diarrhea, moderate to high fever and pain in the RLQ associated with a tender mass or swelling of the terminal ileum arouse suspicion of acute terminal ileitis.[ncbi.nlm.nih.gov]
  • Abstract Collagenous colitis is a rare clinical and pathological entity characterized by watery diarrhea and deposition of collagen beneath the surface epithelium of the colon. Its etiology is unknown.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Older children had abdominal pain or irritability more frequently than younger children (P 0.004). CONCLUSIONS: In Yersinia enterocolitica infections, younger children are predisposed to diarrhea and older children are predisposed to abdominal pain.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Y. enterocolitica infection should be considered as a cause of abdominal pain mimicking appendicitis in patients with underlying risk factors (including certain sickle cell patients).[ncbi.nlm.nih.gov]
  • At first admission, 184 patients had abdominal pain; 200, diarrhea; 45, vomiting; and 36, weight loss. Ulcerative colitis was diagnosed in 7 patients, Crohn's disease in 2, and unspecific colitis in 11.[ncbi.nlm.nih.gov]
  • Abstract A 69-year-old woman with a 5-wk history of diarrhea and abdominal pain was found to have multiple perforations of the terminal ileum.[ncbi.nlm.nih.gov]
  • The patient was a five-year-old girl from a poor Muslim family, and admitted to ICDDR,B's Treatment Centre with complaints of abdominal pain, low-grade fever and diarrhoea.[ncbi.nlm.nih.gov]
Food Poisoning
  • Not refrigerating dairy products and those containing mayonnaise for example Eating food beyond expiry date Further Reading What is Food poisoning? Food poisoning Symptoms Food poisoning Diagnosis Food poisoning Treatments[news-medical.net]
  • Y. enterocolitica (Y. e.) and Y. pseudotuberculosis (Y. p.) are pathogenic bacteria to cause food poisoning. They are infrequently isolated from stool of patients with diarrhea, but it is necessary to isolate them as the pathogen specifically.[webview.isho.jp]
  • poisoning A05.2 Foodborne Clostridium perfringens [Clostridium welchii] intoxication A05.3 Foodborne Vibrio parahaemolyticus intoxication Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.[icd10data.com]
Abdominal Cramps
  • Intermediate incubation from about 1 to 3 days These infections may affect the large intestine or colon leading to bloody diarrhea, dysentery with passage of mucus along with severe abdominal cramps.[news-medical.net]
Right Lower Quadrant Tenderness
  • Four of the Pediatric Surgery patients presented with abdominal pain and right lower quadrant tenderness. The preliminary diagnosis of appendicitis was excluded during hospitalization and none of them underwent appendectomy.[ncbi.nlm.nih.gov]
Arthritis
  • Abstract The majority of patients with reactive arthritis have the major histocompatibility complex class I gene HLA-B27.[ncbi.nlm.nih.gov]
  • The experimental rat model turned out to be a suitable model for studying Yersinia-induced aseptic arthritis. Lewis- and SHR rats proved to be arthritis-susceptible.[ncbi.nlm.nih.gov]
  • The present results indicate that not all cases of acute Y. ent. arthritis remit, but some persist, usually with an intermittent course, and develop into rheumatoid arthritis or allied conditions.[ncbi.nlm.nih.gov]
  • Arthritis was observed in 13 children and extensive lymphadenopathy in 11; 1 child had septicemia with pleurisy, 1 had vasculitis, 1 had cholecystitis and 4 had erythema nodosum.[ncbi.nlm.nih.gov]
  • It has been implicated to cause enterocolitis, terminal ilitis. diarrhoea, mesenteric lymphadenitis and arthritis in man.[ncbi.nlm.nih.gov]

Workup

With a properly obtained patient history and a detailed physical examination, a presumptive diagnosis of Yersinia enterocolitica infection can be made. During the interview, the physician should assess whether the patient recently consumed undercooked or unprocessed pork or dairy products, whereas the presence of bloody stools may narrow the list of causative agents responsible for the infection. To confirm Yersinia enterocolitica as the culprit, microbiological studies need to be used. One of the first and most important investigations are stool cultures (although blood, peritoneal fluid, throat swabs, and excised mesenteric lymph nodes might also be used for cultivation) but their long turnaround time mandates the use of other methods, such as serologic and molecular studies [3] [6]. Enzyme-linked immunosorbent assay (ELISA), mainly used in the setting of chronic infections, is a reliable serologic study that can detect IgA, IgM or IgG antibodies, while polymerase chain reaction (PCR) is now regarded as an optimal procedure, being able to provide results within a very short time span [3] [6].

Colitis
  • We propose that Yersinia enterocolitica infection may be a triggering factor for the development of collagenous colitis in some cases. Duodenal villous atrophy not responding to gluten withdrawal is common in association with collagenous colitis.[ncbi.nlm.nih.gov]
  • Ulcerative colitis was diagnosed in 7 patients, Crohn's disease in 2, and unspecific colitis in 11. Mesenteric lymphadenitis or ileitis were found in 43 of 56 patients at laparotomy. The patients were followed for 4 to 14 years (1987).[ncbi.nlm.nih.gov]
  • The patients were followed for 4-14 years (1987). 36/160 readmitted patients had abdominal pain and 26 had diarrhea; chronic colitis was demonstrated in 4.[ncbi.nlm.nih.gov]
  • […] and colitis NOS ( A09 ) neonatal diarrhea (noninfective) ( P78.3 ) psychogenic diarrhea ( F45.8 ) due to Yersinia enterocolitica A04.6 infectious NOS A09 ICD-10-CM Diagnosis Code A09 Infectious gastroenteritis and colitis, unspecified 2016 2017 2018[icd10data.com]
  • カテゴリ 感染症 階層分類 感染症疾患 [BR: jp08401 ] 細菌感染症 エンテロバクテリアによる感染症 H00298 エルシニア感染症 ICD-11 による疾患分類 [BR: jp08403 ] 01 Certain infectious or parasitic diseases Gastroenteritis or colitis of infectious origin Bacterial intestinal infections 1A05 Intestinal infections[genome.jp]
Liver Biopsy
  • A liver biopsy revealed granulomatous hepatitis. Follow-up after six months revealed normal liver function and histology.[ncbi.nlm.nih.gov]

Treatment

  • Patients with the ultimate diagnosis of focal Y. enterocolitica infection continued treatment with intramuscular ceftriaxone or intravenous trimethoprim/sulfamethoxazole (TMP/SMX) for 7 days, whereas those with septicemia continued treatment with intravenous[ncbi.nlm.nih.gov]
  • In three patients initial treatment with ampicillin and gentamicin was not effective. Augmentin was well tolerated and no toxic effects were detected on biochemical and haematological follow-up.[ncbi.nlm.nih.gov]
  • The patient was a five-year-old girl from a poor Muslim family, and admitted to ICDDR,B's Treatment Centre with complaints of abdominal pain, low-grade fever and diarrhoea.[ncbi.nlm.nih.gov]
  • All bacteremic patients responded to cefotaxime treatment.[ncbi.nlm.nih.gov]
  • There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.[healthychildren.org]

Etiology

  • Its etiology is unknown. We present a careful retrospective clinicopathological analysis of six patients with collagenous colitis diagnosed at our hospital during a three-year period.[ncbi.nlm.nih.gov]
  • It is proposed that the time has come for a classification of these diseases based on their etiology, in order to replace the present symptom-based treatment with a causal one, and to institute prophylactic measures.[ncbi.nlm.nih.gov]

Epidemiology

  • Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen[books.google.com]
  • PURPOSE: We describe certain clinical, epidemiologic, and host-susceptibility features of Yersinia enterocolitica infection in the context of a patient with underlying risk factors.[ncbi.nlm.nih.gov]
  • Infection Control & Hospital Epidemiology ISSN: 0899-823X EISSN: 1559-6834 URL: /core/journals/infection-control-and-hospital-epidemiology Unfortunately you do not have access to this content, please use the Get access link below for information on how[cambridge.org]
  • An epidemiologic investigation demonstrated that illness was associated with drinking of chocolate milk purchased in school cafeterias, and Y. enterocolitica 0:8 was subsequently isolated from the milk.[ncbi.nlm.nih.gov]
  • , Norwegian Institute of Public Health, Oslo, Norway 2 European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Control and Prevention (ECDC), Stockholm, Sweden 3 Department of Foodborne Infections, Norwegian Institute[eurosurveillance.org]
Sex distribution
Age distribution

Pathophysiology

  • The possible pathophysiological association between patient clinical condition and Yersinia bacteraemia is discussed, along with the review of literature. Downloads month by month Downloads Download data is not yet available.[pagepressjournals.org]

Prevention

  • Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen[books.google.com]
  • We conclude that Y. enterocolitica is a significant cause of morbidity in our patients with thalassemia and that prompt antibiotic therapy might prevent life-threatening conditions as well as a complicated course with long term sequelae.[ncbi.nlm.nih.gov]
  • We believe that the importance of Y. enterocolitica infection in children has been neglected and that results from this study can be used to develop preventive recommendations.[ncbi.nlm.nih.gov]
  • As with all cases of diarrhea, fluids are given to prevent or treat dehydration.[healthychildren.org]
  • Many suggestions for the prevention of this problem have been put forward reflecting the fact that there is as yet no perfect solution.[ncbi.nlm.nih.gov]

References

Article

  1. Huovinen E, Sihvonen LM, Virtanen MJ, Haukka K, Siitonen A, Kuusi M. Symptoms and sources of Yersinia enterocolitica-infection: a case-control study. BMC Infect Dis. 2010;10:122.
  2. Bottone EJ. Yersinia enterocolitica: the charisma continues. Clin Microbiol Rev. 1997;10(2):257–276.
  3. Fredriksson-Ahomaa M, Stolle A, Korkeala H. Molecular epidemiology of Yersinia enterocolitica infections. FEMS Immunol Med Microbiol. 2006;47(3):315-329.
  4. Fredriksson-Ahomaa M, Stolle A, Siitonen A, Korkeala H. Sporadic human Yersinia enterocolitica infections caused by bioserotype 4/O:3 originate mainly from pigs. J Med Microbiol. 2006;55:747–749.
  5. Ostroff SM, Kapperud G, Hutwagner LC, et al. Sources of sporadic Yersinia enterocolitica infections in Norway: a prospective case-control study. Epidemiol Infect. 1994;112(1):133–141.
  6. Bancerz-Kisiel A, Szweda W. Yersiniosis - a zoonotic foodborne disease of relevance to public health. Ann Agric Environ Med. 2015;22(3):397-402.
  7. Rosner BM, Stark K, Werber D. Epidemiology of reported Yersinia enterocolitica infections in Germany, 2001-2008. BMC Public Health. 2010;10:337.
  8. Le Guern AS, Martin L, Savin C, Carniel E. Yersiniosis in France: overview and potential sources of infection. Int J Infect Dis. 2016;46:1-7.
  9. Chakraborty A, Komatsu K, Roberts M, et al. The Descriptive Epidemiology of Yersiniosis: A Multistate Study, 2005–2011. Public Health Rep. 2015;130(3):269-277.

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Last updated: 2018-06-21 17:48