YERSINIA ENTEROCOLITICA

 

YERSINIA ENTEROCOLITICA

 

DEFINITION:

A bacterial infectious disease of the small bowel caused by Y. enterocolitica resulting in a dysenteric diarrhea.

EPIDEMIOLOGY:

  • incidence: ?
  • risk factors:
    • age: all ages with peak at 2 years
    • season: peak in cold seasons
    • route: indirect: animals, food, milk, water
    • environ: endemic & epidemic (Canada, N. Europe)
    • High risk groups include debilitated and immunocomprimised patients (often have septicemia with metastatic abscesses or intestinal perforation) and iron-overloaded patients (i.e., hemolytic anemia).
  • incubation period: 2 days

PATHOGENESIS:

1. Background

  • Yersinia enterocolitica is a gram negative rod
    • invades Peyer patches and regional lymph nodes in the distal ileum (mesenteric adenitis). Systemic spread and microabscess production can occur. The terminal ileitis can include the appendix.

CLINICAL FEATURES:

1. Diarrhea

  • mucousy/bloody diarrhea (dysentery)
  • preschool children are often affected by both fever & diarrhea while older kids tend to present with only diarrhea of variable severity
  • usually lasts at least 7 days
  • associated symptoms include abdominal pain

2. Complications

1. Reiter Syndrome

  • conjunctivitis
  • erythema nodosum
  • myocarditis
  • uveitis

2. Infections

  • meningitis
  • carditis
  • hepatitis
  • osteomyelitis
  • septicemia
  • thyroiditis

3. Graves' Disease

  • an antibody is produced to a protein from Yersinia which cross reacts with the TSH receptor

4. Others

  • relapsing diarrhea
  • dehydration
  • enteropathica arthropathy
  • mesenteric lymphadenitis

INVESTIGATIONS:

1. Stool

  • diagnosis is best made by bacterial culture (cold enrichment)
  • Y. enterocolitica can grow at 4 C and 25 C and this character aids in identifying the organism; it is mobile at 25 C but not at 37 C

MANAGEMENT:

1. Supportive

  • oral rehydration fluid (ORF) or intravenous rehydration

2. Antibiotics

  • Septra
  • Chloramphenicol
  • Others
    • Piperacillin, Ciprofloxacin

 

 

 

 

Pediatric Database - YERSINIA ENTEROCOLITICA

Pediatric Organization - Pedbase [at] Gmail.com