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[Chronic recurrent fever as the sole symptom of Yersinia enterocolitica infection]
U Ottermann1, S Mravak, P G Kremsner
1Landesinstitut für Tropenmedizin, Landesmedizinaluntersuchungsamt, Berlin.
Abstract:
Recurrent fever lasting for nine months up to ten years occurred in seven women and three men, with fever of up to 39 degrees C lasting from two to seven days. All patients had travelled outside of Germany at least one year previously. Micro-Widal reaction revealed antibodies against Yersinia enterocolitica (serotype 0:3 or 0:9), with a titre of between 1:80 and 1:1280. Antibiotic treatment (doxycycline or cotrimoxazole) brought cure in all ten. The antibody titres fell in seven of nine patients; titres could not be followed in one.
Insights
Recurrent fever in ten patients was linked to Yersinia enterocolitica infection, likely acquired abroad. Antibiotic treatment with doxycycline or cotrimoxazole successfully cured all cases, with antibody levels decreasing in most.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Recurrent fever is a challenging clinical presentation.
- Yersinia enterocolitica infections can manifest with prolonged symptoms.
- Travel history is crucial in diagnosing infectious diseases.
Purpose of the Study:
- To investigate the cause of prolonged recurrent fever in a cohort of patients.
- To identify the role of Yersinia enterocolitica in these cases.
- To evaluate the efficacy of antibiotic treatment for Yersinia enterocolitica-induced fever.
Main Methods:
- Patient cohort identification based on recurrent fever symptoms.
- Serological testing using Micro-Widal reaction for Yersinia enterocolitica antibodies.
- Analysis of antibody titres and patient travel history.
- Assessment of treatment outcomes with doxycycline or cotrimoxazole.
Main Results:
- Ten patients (7 women, 3 men) presented with recurrent fever (up to 39°C, 2-7 days duration) lasting 9 months to 10 years.
- All patients had prior travel history outside Germany.
- Positive Micro-Widal reaction for Yersinia enterocolitica (serotype 0:3 or 0:9) with titres ranging from 1:80 to 1:1280.
- Complete cure was achieved in all ten patients following antibiotic therapy.
- Antibody titres decreased in 7 of 9 patients whose titres were monitored post-treatment.
Conclusions:
- Yersinia enterocolitica infection should be considered in patients with prolonged recurrent fever, especially with a history of international travel.
- Antibiotic treatment, including doxycycline or cotrimoxazole, is effective in eradicating Yersinia enterocolitica and resolving recurrent fever.
- Serological monitoring can indicate treatment response, with falling antibody titres suggesting successful clearance of infection.