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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+ | *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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+ | * 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]] |
+ | *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]] |
+ | *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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+ | *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: |
**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]] |
Latest revision as of 13:51, 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