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Section 3. Summaries of Infectious Diseases
Yersinia enterocolitica and Yersinia pseudotuberculosis Infections
(Enteritis and Other Illnesses)
Clinical ManifestationsEtiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
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CLINICAL MANIFESTATIONS
Yersinia enterocolitica causes several age-specific syndromes and a variety of other less common presentations. Infection with Y enterocolitica typically manifests as fever and diarrhea in young children; stool often contains leukocytes, blood, and mucus. Relapsing disease and, rarely, necrotizing enterocolitis also have been described. In older children and adults, a pseudoappendicitis syndrome (fever, abdominal pain, tenderness in the right lower quadrant of the abdomen, and leukocytosis) predominates. Bacteremia with Y enterocolitica most often occurs in children younger than 1 year of age and in older children with predisposing conditions, such as excessive iron storage (eg, desferrioxamine use, sickle cell disease, beta-thalassemia) and immunosuppressive states. Focal manifestations of Y enterocolitica are uncommon and include pharyngitis, meningitis, osteomyelitis, pyomyositis, conjunctivitis, pneumonia, empyema, endocarditis, acute peritonitis, abscesses of the liver and spleen, and primary cutaneous infection. Postinfectious sequelae with Y enterocolitica infection include erythema nodosum, proliferative glomerulonephritis, and reactive arthritis; these sequelae occur most often in older children and adults, particularly people with HLA-B27 antigen.
The major manifestations of Yersinia pseudotuberculosis infection are fever, scarlatiniform rash, and abdominal symptoms. Acute pseudoappendiceal abdominal pain is common, resulting