II. Pathophysiology

  1. Characteristics
    1. Yersinia enterocolitica is a facultative Anaerobic Gram Negative Rod in Enterobacteriaceae family
      1. Closely related to Yersinia pestis (Bubonic Plague)
    2. Motile (with flagella)
    3. Grows at refrigerator Temperatures
  2. Exposure sources
    1. Natural Hosts: Wild and domestic mammals, birds
    2. Waterborne Illness source
      1. Natural waters in which E. coli is not present
    3. Foodborne Illness source (esp. children)
      1. Contaminated meat (esp. pork products, as well as poultry and seafood)
      2. Dairy products
      3. Outbreaks have also occurred with fruits, vegetables, stewed and fermented products
    4. Fecal-oral tranmission
      1. Bacterial shedding in stool continues up to 3-4 months after symptom resolution
  3. Pathogenesis of Bacterial Gastroenteritis (Yersiniosis)
    1. Systemic invasion (similar to Salmonella typhi)
      1. Yersinia enterocolitica binds and invades intestinal epithelial cells
      2. May spread to regional Lymph Nodes, and in some cases, cause bacteremia and Sepsis
    2. Enterotoxin
      1. Similar to E. coli Heat Stable Enterotoxin (ST)
      2. Causes Diarrhea

III. Findings: Bacterial Gastroenteritis

  1. Fever
  2. Nausea and Vomiting
  3. Abdominal Pain (esp. RLQ Abdominal Pain)
  4. Diarrhea
    1. Often prolonged (2-3 weeks)
    2. Bloody Diarrhea may occur (esp. children)

IV. Differential Diagnosis

  1. See Acute Diarrhea
  2. Appendicitis
    1. Yersinia causes Mesenteric Lymphadenitis and Mucosal Ulceration of the terminal ileum (pseudo-Appendicitis)

V. Labs

  1. See Acute Diarrhea
  2. Diagnosis
    1. Enteric Pathogens Nucleic Acid Test Panels (preferred) OR
    2. Stool Culture on selective growth medium

VI. Management: General

  1. See Acute Diarrhea
  2. Severe cases with systemic infection (Yersiniosis) and Sepsis may occur
  3. Supportive Care
    1. Oral Rehydration

VII. Management: Antibiotics

  1. Antibiotic Indications
    1. Severe disease
    2. Bacteremia
    3. Antibiotics not needed in mild disease or uncomplicated enteritis
  2. Severe disease - first line regimen (combined Doxycycline with Aminoglycoside)
    1. Doxycycline 100 mg IV twice daily AND
    2. Gentamicin or Tobramycin 5 mg/kg/day every 24 hours
  3. Severe disease - alternative regimens
    1. Trimethoprim-Sulfamethoxazole (TMP-SMZ) DS 160/180 mg twice daily for 5 days
    2. Ciprofloxacin 500 mg orally twice daily for 7-10 days
  4. References
    1. Gilbert (2013) Sanford Guide

VIII. Complications

  1. Sepsis
  2. Extraintestinal Yersiniosis (post-infectious, primarily in Immunocompromised patients)
    1. Erythema Nodosum
    2. Reactive Arthritis
    3. Glomerulonephritis

IX. Prevention

  1. See Prevention of Foodborne Illness
  2. See Prevention of Waterborne Illness
  3. Prevent fecal-oral transmission
    1. Patients, care givers and their close contacts should practice good Hand Hygiene
    2. Bacterial shedding in stool continues up to 3-4 months after symptom resolution

X. Resources

  1. Yersinia enterocolitica (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK499837/

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Related Studies

Ontology: Yersinia enterocolitica (C0043406)

Definition (NCI_CDISC) Any bacterial organism that can be assigned to the species Yersinia enterocolitica.
Definition (NCI) A species of facultatively anaerobic, Gram negative, rod shaped bacteria in the phylum Proteobacteria. This species is motile, positive for urease, and ornithine decarboxylase, and negative for oxidase, and citrate. It is able to ferment cellobiose, sucrose, and sorbose but not raffinose, melibiose, or rhamnose. Y. enterocolitica is commensal and a pathogen that causes Yersiniosis, which infects children that have ingested contaminated meat or milk.
Definition (MSH) A species of the genus YERSINIA, isolated from both man and animal. It is a frequent cause of bacterial gastroenteritis in children.
Concepts Bacterium (T007)
MSH D015008
SnomedCT 65255000
English Bacterium enterocoliticum, Yersinia enterocolitica (Schleifstein and Coleman 1939) Frederiksen 1964, yersinia enterocolitica, YERSINIA ENTEROCOLITICA, Yersinia Enterocolitica, PASTEURELLA ENTEROCOLITICA, Pasteurella enterocolitica, Yersinia enterocolitica (organism), Yersinia enterocolitica
Swedish Yersinia enterocolitica
Czech Yersinia enterocolitica
Finnish Yersinia enterocolitica
Russian IERSINIOZA VOZBUDITEL', YERSINIA ENTEROCOLITICA, ИЕРСИНИОЗА ВОЗБУДИТЕЛЬ
Croatian YERSINIA ENTEROCOLITICA
Polish Pałeczka jersiniozy, Yersinia enterocolitica
Norwegian Yersinia enterocolitica
Spanish Yersinia enterocolitica (organismo), Yersinia enterocolitica
French Yersinia enterocolitica
German Yersinia enterocolitica
Italian Yersinia enterocolitica
Dutch Yersinia enterocolitica
Portuguese Yersinia enterocolitica

Ontology: yersiniosis; sepsis (C1409731)

Concepts Disease or Syndrome (T047)
English sepsis; yersiniosis, yersiniosis; sepsis
Dutch sepsis; yersiniose, yersiniose; sepsis