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Published on: May 31, 2024
Difficulties in diagnosing terminal ileitis due to Yersinia pseudotuberculosis
H F Wunderink1, P M Oostvogel, I H M E Frénay
1Department of Medical Microbiology, Leiden University Medical Center, E1-200, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands, h.f.wunderink@lumc.nl.
Summary
Three patients with terminal ileitis recovered after ciprofloxacin treatment for Yersinia pseudotuberculosis infection. A rare virulence plasmid-negative strain was identified, highlighting the need for specific diagnostic methods for yersiniosis.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Terminal ileitis is an inflammation of the ileum, often presenting with non-specific symptoms.
- Yersinia pseudotuberculosis is a bacterial pathogen that can cause gastrointestinal illness, including ileitis.
- Conventional diagnostic methods for yersiniosis are increasingly being replaced by molecular techniques.
Observation:
- Three patients presented with terminal ileitis and positive fecal cultures for Yersinia pseudotuberculosis.
- A virulence plasmid (pYV)-negative Y. pseudotuberculosis isolate was recovered from one patient, a rare occurrence in human disease.
- All three patients were successfully treated with ciprofloxacin and experienced full recovery.
Findings:
- This study documents a second case of pYV-negative Yersinia pseudotuberculosis associated with human illness.
- The successful treatment of these patients with ciprofloxacin suggests its efficacy against Y. pseudotuberculosis infections.
- The findings underscore potential diagnostic challenges with the shift towards molecular testing.
Implications:
- Clinicians should consider Yersinia pseudotuberculosis in the differential diagnosis of terminal ileitis, especially when conventional cultures are performed.
- The emergence of pYV-negative strains warrants further investigation into their pathogenicity and prevalence.
- Implementing specific culture media or PCR assays for Yersinia pseudotuberculosis is recommended for accurate diagnosis in suspected cases of terminal ileitis.
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