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]
- 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]
- Camping
Secondary transmission cannot be eliminated as a source of infection in the military camps. The most likely source of the outbreak was salad mix containing imported radicchio rosso, due to its long shelf life. [eurosurveillance.org]
- 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]
- Intravenous Administration
An empirical therapy was therefore started with the intravenous administration of daptomycin (500 mg die), ertapenem (1 g die), and fluconazole (400 mg die). [frontiersin.org]
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]
- Intestinal Perforation
Intestinal perforation is a rare complication of the disease. To date only eleven cases of surgical complications arising from abscess and intestinal perforation due to Yersinia enterocolitica have been reported in literature. [mattioli1885journals.com]
Abstract Despite the frequency of gastrointestinal disease caused by Yersinia enterocolitica, intestinal perforation is a rare complication of this infection and to date only eight cases have been reported in the English literature. [ncbi.nlm.nih.gov]
Yersinia enterocolitica Infection Complicated by Intestinal Perforation. [jamanetwork.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]
Cardiovascular
- Hypertension
Delivery Models Health Care Economics, Insurance, Payment Health Care Policy Health Care Quality Health Care Reform Health Care Safety Health Care Workforce Health Disparities Health Informatics Health Policy Hematology History of Medicine Humanities Hypertension [jamanetwork.com]
Musculoskeletal
- Arthritis
Abstract The majority of patients with reactive arthritis have the major histocompatibility complex class I gene HLA-B27. [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]
Neurologic
- Seizure
It may affect the brain causing seizures). Bacterial infections with long incubation period include Listeria and Brucella infection due to unpasteurized milk, soft cheeses, and poorly stored processed meats and poultry. [news-medical.net]
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]
HLA Type
- HLA-B27
Thus, HLA-B27 transgenic mice have higher mortality and morbidity from infection with Y. enterocolitica 0:8 WA than corresponding HLA-B27- littermates. [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]
Reactive arthritis This is associated with HLA-B27 (found in approximately 80% of affected patients). Most commonly reported in Scandinavia, polyarticular arthritis can occur after Y enterocolitica infection. [emedicine.medscape.com]
The pathogenesis is likely due to an immune response that Yersinia antigens cross-reacts with host antigens, which the host has HLA-B27 positivity making them susceptible to arthritis (20). [apm.amegroups.com]
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]
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]
Seite 290 - Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: A meta-analysis. Hepatology 1999; 29: 1655-61 6. [books.google.de]
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.