Yersinia enterocolitica: Difference between revisions
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Yersinia enterocolitica
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=== Microbiology === |
=== 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 |
*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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Revision as of 00:27, 15 October 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
