View source for Yersinia enterocolitica

{{DISPLAYTITLE:''Yersinia enterocolitica''}}

==Background==

=== Microbiology ===

*[[Stain::Gram-negative]] [[Shape::bacillus]]
*Serogroup O:3 and O:9 have a less effective siderophore that requires presence of iron overload or iron chelation to be invasive

=== Epidemiology ===

*Acquired from unpasteurized milk, undercooked meat (especially pork), contaminated water
**Classic association with chitterlings

=== Risk Factors ===

* Iron overload
* Treatment with iron chelators, including [[deferoxamine]]
* Can be acquired from blood transfusion

==Clinical Manifestations==

*Incubation period of [[Usual incubation period::1 to 14 days]]
*Classically causes [[Causes::gastroenteritis]]
**Fever with blood diarrhea, vomiting
**May cause [[Causes::terminal ileitis]], which causes right lower quadrant pain mimicking [[appendicitis]] ([[Causes::pseudoappendicitis]])
*Concurrent [[Causes::pharyngitis]] in 20%, can can be isolated from throat swabs
*Complications include [[Causes::bacteremia]], with hematogenous dissemination with metastatic abscesses in the [[Causes::liver abscess|liver]] and [[Causes::splenic abscess|spleen]] and [[Causes::mesenteric adenitis]]
*Can also cause [[Causes::pneumonia]], [[Causes::septic arthritis]], [[Causes::meningitis]], [[Causes::panophthalmitis]], [[Causes::cellulitis]], [[Causes::empyema]], [[Causes::osteomyelitis]], and [[Causes::infective endocarditis]] or [[Causes::mycotic aneurysm]]
**More common in immunodeficiency or iron overload
*Can lead to post-infectious [[Causes::reactive arthritis]], [[Causes::erythema nodosum]], and [[Causes::glomerulonephritis]]

==Management==

*Stop [[deferoxamine]], if taking
*Unclear if antimicrobial treatment is beneficial unless severe
*Antibiotics are generally indicated in:
**Severe disease
**Extraintestinal disease, including [[meningitis]], [[cellulitis]], [[pneumonia]], [[osteomyelitis]], and [[endocarditis]]
**High risk populations, including the elderly, people with [[diabetes]], people with [[cirrhosis]], and immunocompromised patients
*Options include [[Is treated by::ciprofloxacin]], [[Is treated by::ceftriaxone]], [[Is treated by::TMP-SMX]], [[Is treated by::doxycycline]], and [[Is treated by::aminoglycosides]]
**Duration typically 7 to 14 days

[[Category:Gram-negative bacilli]]