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Clinical manifestations of Yersinia pseudotuberculosis infection in children
Insights
An outbreak of Yersinia pseudotuberculosis serotype Ia infection revealed that many infections can be subclinical, indicated by antibody responses in individuals without symptoms. This suggests varying bacterial capacities for causing post-infection complications.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- An outbreak of Yersinia pseudotuberculosis serotype Ia infection occurred, involving 34 cases.
- Clinical manifestations and immune responses were analyzed in affected individuals.
Purpose of the Study:
- To analyze clinical manifestations during a Yersinia pseudotuberculosis serotype Ia outbreak.
- To investigate the proportion of subclinical infections and potential post-infection complications.
Main Methods:
- Diagnosis was confirmed using enzyme immunoassay and stool culture.
- Antibody responses (IgM and IgG) were measured in blood samples from 101 children.
- Clinical signs and symptoms were collected via questionnaire.
Main Results:
- Yersinia pseudotuberculosis Ia antibodies were detected in 25% of symptomatic and 18% of asymptomatic pupils.
- Fever and abdominal pain were the most common symptoms.
- Mesenteric lymphadenitis was diagnosed in three children initially suspected of appendicitis; one developed reactive arthritis.
Conclusions:
- A significant proportion of Yersinia pseudotuberculosis infections may be subclinical.
- Individual Yersinia pseudotuberculosis strains may differ in their ability to cause post-infection complications.
Abstract:
The clinical manifestations of infection were analysed during an outbreak of 34 cases of Yersinia pseudotuberculosis serotype Ia infection. The diagnosis was based on the results of enzyme immunoassay and verified by stool culture in five cases. The first four patients were pupils from the same school, and information on any signs and symptoms of infection was obtained by questionnaire from pupils of the school. A blood sample was obtained from 101 children. Strong IgM and IgG antibody responses to Yersinia pseudotuberculosis Ia were found in 13 (25%) of the 52 pupils who reported signs and symptoms of infection and in 9 (18%) of the 49 with no manifestations of infection. The vigorous immune response also resulted in effective opsonization of the causative microorganism. The most common symptoms were fever and abdominal pain. Three children operated on because of suspected appendicitis were found to have mesenteric lymphadenitis. Only one patient developed reactive arthritis. Analysis showed that a remarkable proportion of Yersinia pseudotuberculosis infections may be subclinical, and that individual Yersinia pseudotuberculosis strains may have different capacities to cause postinfection complications.