Yersiniosis

Yersinia enterocolitica
Other names: Yersinia infection[1]
Top:Mechanism of pathogenesis of Y. enterocolitica[2] Bottom:Colony of Yersinia enterocolitica on Cefsoludin-Irgasan-Novobiocin (CIN) agar
Specialty	Infectious disease
Symptoms	Abdominal pain, nausea, vomiting, fever[3]
Complications	Cholangitis,septicemia,toxic megacolon,hepatic abscess[3]
Causes	Yersinia enterocolitica[3]
Diagnostic method	Stool culture[3]
Differential diagnosis	Diverticulitis,Inflammatory bowel disease[3]
Treatment	Aminoglycosides or trimethoprim-sulfamethoxazole[3]

Yersiniosis is an infectious disease caused by a bacterium of the genus Yersinia. Infection with Y. enterocolitica occurs most often in young children.^[3][4][5]

The infection is thought to be contracted through the consumption of undercooked meat products, unpasteurized milk, or water contaminated by the bacteria. It has been also sometimes associated with handling raw chitterlings.^[6][7] Another bacterium of the same genus, Yersinia pestis, is the cause of Plague.^[8]

As to management we find that the drugs of choice are aminoglycosides or trimethoprim-sulfamethoxazole^[3]

Signs and symptoms

Infection with Y. enterocolitica can cause a variety of symptoms depending on the age of the person infected. Common symptoms in children are fever, abdominal pain, and diarrhea, which is often bloody. Symptoms typically develop 4 to 7 days after exposure and may last 1 to 3 weeks or longer. In older children and adults, right-sided abdominal pain and fever may be the predominant symptoms, and may be confused with appendicitis. In a small proportion of cases, complications such as skin rash, joint pains, ileitis, erythema nodosum, and sometimes sepsis, acute arthritis^[9] or the spread of bacteria to the bloodstream (bacteremia) can occur.

Complications

In terms of the complications of Yersiniosis we find the following:^[3]

• Paralytic ileus
• Cholangitis
• Septicemia
• Toxic megacolon
• Hepatic abscess
• Splenic abscess
• Renal abscess

Cause

The etiology of Yersiniosis is Yersinia enterocolitica, humans are hosts who do not contribute to the pathogens life cycle ^[3] Most people become infected by eating contaminated food, especially raw or undercooked pork, or through contact with a person who has prepared a pork product, such as chitlins.^[5] For example, babies and infants can be infected if their caretakers handle contaminated food and then do not wash their hands properly before handling the child or the child's toys, bottles, or pacifiers.^[5] People occasionally become infected after drinking contaminated milk or untreated water, or after contact with infected animals or their feces.^[5] On rare occasions, people become infected through person-to-person contact.^[5] For example, caretakers can become infected if they do not wash their hands properly after changing the diaper of a child with yersiniosis.^[5] Even more rarely, people may become infected through contaminated blood during a transfusion.^[5]

Risk factors

In terms of risk factors that may increase the possibility of an individual acquiring Yersiniosis is as follows:^[10][11]

• Poor hygiene

• Hemochromatosis

• Contaminated food

Mechanism

In terms of the mechanism of Yersiniosis we find that it involves the invasion of epithelial cells,as well as the colonization of lymphoid tissue, and spread to other organs. Among the pathogenic properties of Yersinia are chromosomally mediated effects and plasmid-mediated mechanisms^[3][12]

Diagnosis

As to the diagnosis of Yersiniosis we find that the isolation of the organism can be done from:^[11]

• Stool
• Blood
• Cerebrospinal fluid
• Mesenteric lymph nodes
• Peritoneal fluid
• Throat swab

Differential diagnosis

In terms of the DDX we find that the following should be considered:^[3]

• Diverticulitis
• Inflammatory bowel disease
• Medication-associated colitis
• Cancer of colon
• Ischemic colitis
• HIV(developing countries)

Treatment

Treatment for gastroenteritis due to Y. enterocolitica is not needed in the majority of cases. Severe infections with systemic involvement (sepsis or bacteremia) often requires aggressive antibiotic therapy; the drugs of choice are aminoglycosides or trimethoprim-sulfamethoxazole. Alternatives include cefotaxime, fluoroquinolones, and co-trimoxazole.^[3][13][14]

Epidemiology

The Centers for Disease Control and Prevention estimates that infections with Yersinia enterocolitica cause almost 117,000 illnesses, 640 hospitalizations, and 35 deaths in the United States every year.^[5]

In 2011, there were 7,017 diagnosed cases of yersiniosis in the European Union.^[4] This was a 3.5% increase compared to the prior year.^[4]

In 2011, there were 257 diagnosed cases of yersiniosis in Poland.^[4]

In 2012 in Poland, there was a drop to 231 reported yersiniosis cases.^[4]

Children are infected more often than adults, and the infection is more common in the winter.^[5]

• 
  Yersinia enterocolitica infections in Germany, 2001-2008^[15]
• 
  Geographical distribution of Yersiniosis^[2]

History

As to history 1975 the first case of Yersinia enterocolitica was initially described in Netherlands in the year 1975; many additional cases have been reported worldwide. Y. enterocolitica was first described in 1934 as the cause of an individuals facial abscess^[16][17]

Research

A 2024 article indicates that the biggest breakthrough in Yersiniosis diagnostics is the widespread use of culture-independent diagnostic test, especially syndromic gastrointestinal panels, which have significantly boosted detection rates^[18]

References

External links