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Yersiniosis

Overview

Yersiniosis is a bacterial infection caused by a bacterium of the genus Yersinia. Another bacteria of the same genus causes plague in human beings. Few strains of this bacteria affect human beings. The signs and symptoms of this infection resemble other gastrointestinal infections. In the majority of the cases, no particular treatment options are required for yersiniosis, and the infection recovers on its own. In rare cases, few life-threatening complications may develop, requiring immediate medical attention. 

Causes

The causative bacterium of yersiniosis is Yersinia enterocolitica. This primary source of getting contaminated with this bacteria is pork, but other sources include undercooked meat, unpasteurized milk or dairy items, or contaminated water. 

Risk Factors And Epidemiology

Yersiniosis can occur in anyone, but it most commonly affects children. The risk of getting this infection is higher if you eat undercooked pork or use unpasteurized milk products. Preparation and consumption of chitterlings (pork intestines) is another risk factor. You can spread this infection to infants or young children if you do not handle chitterlings with proper sanitary measures. It can also be transmitted by getting in contact with the stool of an infected person. This risk is higher in regions where personal hygiene and sanitary measure are not practiced.

According to the Centers for Disease Control and Prevention (CDC), approximately 117,000 people are reported with yersiniosis in the United States every year. Out of these, almost 35 people die due to fatal complications of this infection. This infection is more common among children and predominant during winter than summer. 

Signs And Symptoms

Signs and symptoms of yersiniosis may vary depending on the age of the person infected. Symptoms start to develop 4 to 7 days after getting contaminated with the bacteria. In younger children, the early symptoms include fever, abdominal pain, and bloody diarrhea. In older children and adults, this infection can present with right-sided abdominal pain and fever. The right-sided abdominal pain can sometimes be confused with appendicitis. The symptoms of this infection last from 1 to 3 weeks. In some rare cases, the infection may persist for a longer duration and cause complications, including skin rash, joint pain, erythema nodosum, ileitis, acute arthritis, bacteremia, or sepsis. 

Diagnosis

The diagnosis of yersiniosis requires a thorough history followed by a clinical examination. History will include questions regarding intake of undercooked meat, unpasteurized milk products, or handling of pork intestines. Physical examination is done to rule out other possible causes of abdominal pain. The conformational diagnosis of yersiniosis is made by detecting bacteria in stool samples. Keep in mind that most laboratories do not routinely test for yersiniosis. If this infection is suspected, laboratory staff must be informed in advance to prepare for its testing. The samples for this infection can also be obtained from lymph nodes, throat, bile, urine, or blood. 

Differential Diagnosis

Yersiniosis needs to be differentiated from other causes of fever and abdominal pain, including viral infections, bacterial infections, parasitic infections, diverticulitis, ulcerative colitis, and a few other gastrointestinal diseases. 

Treatment

Mild to moderate cases of yersiniosis recover well on their own without any medical treatment. Rest and adequate fluid intake are suggested if a child develops yersiniosis with no complications. It is important to maintain a good hydration level to counterbalance the water loss by diarrhea. The symptoms often recover within 2 to 3 weeks on their own without any complications.

In cases of complicated yersiniosis, which involves sepsis or bacteremia, antibiotic coverage is required to cure this infection. The preferred treatment regimen includes doxycycline with an aminoglycoside. Alternative antibiotics may include ciprofloxacin, cefotaxime, fluoroquinolones, and co-trimoxazole. 

Prognosis

Majority of the cases recover from this infection within 2 to 3 weeks without an antibiotic treatment. Complicated cases of yersiniosis can be managed with aggressive antibiotic therapy. In very rare instances, complications of this infection may lead to death. 

Prevention

Yersiniosis can be prevented by avoiding consuming contaminated products such as raw or undercooked meat, unpasteurized milk or milk products, and chitterlings. If you have to handle pork intestines, wash your hands thoroughly before and after the process. Avoid touching feeders, pacifiers, or baby toys with contaminated hands. Keep separate cutting boards for meat and other animal-based products. Practice basic hygiene and sanitary practices in your kitchen and work environment to limit the spread of this infection.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 10, 2023.

 

References

https://www.cdc.gov/yersinia/index.html#:~:text=Yersiniosis%20is%20an%20infection%20caused,the%20United%20States%20every%20year.

https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119501237.ch102