Yersinia enterocolitica: Difference between revisions
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Yersinia enterocolitica
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==Background== |
==Background== |
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=== Microbiology === |
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*[[Stain::Gram-negative]] [[Cellular shape::bacillus]] |
*[[Stain::Gram-negative]] [[Cellular 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 |
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=== Epidemiology === |
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*Acquired from unpasteurized milk, undercooked meat (especially pork), contaminated water |
*Acquired from unpasteurized milk, undercooked meat (especially pork), contaminated water |
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**Classic association with chitterlings |
**Classic association with chitterlings |
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=== Risk Factors === |
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* Iron overload |
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* Treatment with iron chelators, including [[deferoxamine]] |
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==Clinical Manifestations== |
==Clinical Manifestations== |
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==Management== |
==Management== |
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*Stop [[deferoxamine]], if taking |
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*Unclear if antimicrobial treatment is beneficial unless severe |
*Unclear if antimicrobial treatment is beneficial unless severe |
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*Antibiotics are generally indicated in: |
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**Severe disease |
**Severe disease |
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**Extraintestinal disease, including [[meningitis]], [[cellulitis]], [[pneumonia]], [[osteomyelitis]], and [[endocarditis]] |
**Extraintestinal disease, including [[meningitis]], [[cellulitis]], [[pneumonia]], [[osteomyelitis]], and [[endocarditis]] |
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**High risk populations, including the elderly, people with [[diabetes]], people with [[cirrhosis]], and immunocompromised patients |
**High risk populations, including the elderly, people with [[diabetes]], people with [[cirrhosis]], and immunocompromised patients |
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*Options include [[Is treated by::ciprofloxacin]], [[Is treated by::ceftriaxone]], [[Is treated by::TMP-SMX]], [[Is treated by::doxycycline]], and [[Is treated by::aminoglycosides]] |
*Options include [[Is treated by::ciprofloxacin]], [[Is treated by::ceftriaxone]], [[Is treated by::TMP-SMX]], [[Is treated by::doxycycline]], and [[Is treated by::aminoglycosides]] |
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**Duration typically 7 to 14 days |
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[[Category:Gram-negative bacilli]] |
[[Category:Gram-negative bacilli]] |
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Revision as of 22:13, 13 September 2020
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
Clinical Manifestations
- Incubation period of Usual incubation period:1 to 14 days
- Gastroenteritis, often with pain isolated to right lower quadrant mimicking appendicitis
- Concurrent pharyngitis in 20%, can can be isolated from throat swabs
- Complications include hematogenous dissemination with metastatic abscesses in the liver and spleen, mesenteric adenitis, terminal ileitis, and pseudoappendicitis
- Can lead to reactive arthritis and erythema nodosum
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
