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].
Entire Body System
- Fever
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]
In our case, the patient showed fever and pain in his neck, lumbosacral region and limbs, but no gastrointestinal symptoms. [apm.amegroups.com]
- Reiter Syndrome
Links: Reiter's syndrome traveller's diarrhoea [gpnotebook.co.uk]
Dworkin MS, Shoemaker PC, Goldoft MJ, Kobayashi JM: Reactive arthritis and Reiter’s syndrome following an outbreak of gastroenteritis caused by Salmonella enteritidis. Clin Infect Dis. 2001, 33: 1010-1014. 10.1086/322644. 37. [bmcinfectdis.biomedcentral.com]
- 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]
- Collapse
Spontaneous kyphotic collapse followed by autostabilisation secondary to cervical osteomyelitis in an intravenous drug abuser. Acta Orthop Belg 2007;73:807-11. [PubMed] Berner R, Kist M, Sauer M. [apm.amegroups.com]
Gastrointestinal
- Abdominal Pain
Older children had abdominal pain or irritability more frequently than younger children (P = 0.004). [ncbi.nlm.nih.gov]
- 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]
As with all cases of diarrhea, fluids are given to prevent or treat dehydration. [healthychildren.org]
- 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]
Musculoskeletal
- Arthritis
As we known, Y. enterocolitis is also a common cause of chronic aseptic arthritis, especially in in patients with compromised immune function. [apm.amegroups.com]
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]
Two patients who were HLA‐B27 positive had a reactive arthritis as their dominant complaint. In conclusion, Y. enterocolitica has emerged as a common cause of diarrhea in adults. [onlinelibrary.wiley.com]
Samuel MP, Zwillich SH, Thomson GT, Alfa M, Orr KB, Brittain DC, Miller JR, Phillips PE: Fast food arthritis–a clinico-pathologic study of post-Salmonella reactive arthritis. J Rheumatol. 1995, 22: 1947-1952. 39. [bmcinfectdis.biomedcentral.com]
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].
Colonoscopy
- 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]
[…] 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]
Biopsy
- Liver Biopsy
In a 69-year-old male patient with acute Yersinia enterocolitica infection with positive faecal culture and a serum titre of 1/1280, the liver tests were slightly abnormal. A liver biopsy revealed granulomatous hepatitis. [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]
The limitations restrict the broader applicability of the treatment in this case. [apm.amegroups.com]
Prognosis
Although the septicemia with Y. enterocolitica can lead to complications including liver abscess, arthritis and other symptoms, timely administration of effective antibiotics seems to improve the prognosis. [apm.amegroups.com]
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]
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]
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]
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]
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]
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]
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
- 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.
- Bottone EJ. Yersinia enterocolitica: the charisma continues. Clin Microbiol Rev. 1997;10(2):257–276.
- Fredriksson-Ahomaa M, Stolle A, Korkeala H. Molecular epidemiology of Yersinia enterocolitica infections. FEMS Immunol Med Microbiol. 2006;47(3):315-329.
- 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.
- 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.
- Bancerz-Kisiel A, Szweda W. Yersiniosis - a zoonotic foodborne disease of relevance to public health. Ann Agric Environ Med. 2015;22(3):397-402.
- Rosner BM, Stark K, Werber D. Epidemiology of reported Yersinia enterocolitica infections in Germany, 2001-2008. BMC Public Health. 2010;10:337.
- 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.
- 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.