Yersinia enterocolitica: Difference between revisions
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Yersinia enterocolitica
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=== Microbiology === |
=== Microbiology === |
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*[[Stain::Gram-negative]] [[ |
*[[Stain::Gram-negative]] [[Shape::bacillus]] |
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*Serogroup O:3 and O:9 have a less effective siderophore that requires presence of iron overload or iron chelation to be invasive |
*Serogroup O:3 and O:9 have a less effective siderophore that requires presence of iron overload or iron chelation to be invasive |
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* Iron overload |
* Iron overload |
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* Treatment with iron chelators, including [[deferoxamine]] |
* Treatment with iron chelators, including [[deferoxamine]] |
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* Can be acquired from blood transfusion |
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==Clinical Manifestations== |
==Clinical Manifestations== |
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*Incubation period of [[Usual incubation period:1 to 14 days]] |
*Incubation period of [[Usual incubation period::1 to 14 days]] |
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*Classically causes [[Causes::gastroenteritis]] |
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*[[Causes::Gastroenteritis]], often with pain isolated to right lower quadrant mimicking appendicitis |
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**Fever with blood diarrhea, vomiting |
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**May cause [[Causes::terminal ileitis]], which causes right lower quadrant pain mimicking [[appendicitis]] ([[Causes::pseudoappendicitis]]) |
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*Concurrent [[Causes::pharyngitis]] in 20%, can can be isolated from throat swabs |
*Concurrent [[Causes::pharyngitis]] in 20%, can can be isolated from throat swabs |
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*Complications include hematogenous dissemination with metastatic abscesses in the [[Causes::liver abscess|liver]] and [[Causes::splenic abscess|spleen]] |
*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]] |
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*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]] |
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**More common in immunodeficiency or iron overload |
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==Management== |
==Management== |
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Latest revision as of 17:51, 9 August 2023
Background
Microbiology
- Gram-negative 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 1 to 14 days
- Classically causes gastroenteritis
- Fever with blood diarrhea, vomiting
- May cause terminal ileitis, which causes right lower quadrant pain mimicking appendicitis (pseudoappendicitis)
- Concurrent pharyngitis in 20%, can can be isolated from throat swabs
- Complications include bacteremia, with hematogenous dissemination with metastatic abscesses in the liver and spleen and mesenteric adenitis
- Can also cause pneumonia, septic arthritis, meningitis, panophthalmitis, cellulitis, empyema, osteomyelitis, and infective endocarditis or mycotic aneurysm
- More common in immunodeficiency or iron overload
- Can lead to post-infectious reactive arthritis, erythema nodosum, and 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 ciprofloxacin, ceftriaxone, TMP-SMX, doxycycline, and aminoglycosides
- Duration typically 7 to 14 days
