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Published on: October 22, 2013
Clinical aspects of infection with Yersinia enterocolitica in adults
Abstract:
Yersinia enterocolitica was isolated from the feces of 29 patients over a three-year period following the introduction of a selective culture medium. Y. enterocolitica was the third most common enteric pathogen after Campylobacter jejuni and Salmonella in this series of 3795 specimens from a predominantly adult population. The isolation rate of Y. enterocolitica was 0.9% and this represented 15.8% of positive cultures. The usual symptoms of Yersinia infection were diarrhea (93%) and abdominal pain (72%), often associated with tenderness in the right iliac fossa and fever. Fourteen patients required admission to hospital and four came to surgery for possible appendicitis. Acute terminal ileitis and mesenteric lymphadenitis were noted in each case. Two patients who were HLA-B27 positive had a reactive arthritis as their dominant complaint. In conclusion, Y. enterocolitica has emerged as a common cause of diarrhea in adults. It is an important cause of symptoms resembling those of acute appendicitis and is occasionally complicated by reactive arthritis.
Insights
Yersinia enterocolitica is a common cause of adult diarrhea, mimicking appendicitis symptoms. This enteric pathogen can also lead to reactive arthritis in some patients.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Yersinia enterocolitica infections are increasingly recognized in adults.
- Selective culture media have improved the detection of enteric pathogens.
Purpose of the Study:
- To determine the incidence and clinical significance of Yersinia enterocolitica infections in an adult population.
- To describe the spectrum of symptoms and complications associated with Yersinia enterocolitica.
Main Methods:
- A three-year retrospective study of fecal specimens.
- Isolation and identification of Yersinia enterocolitica using a selective culture medium.
- Clinical data review for patients with confirmed Yersinia enterocolitica infection.
Main Results:
- Yersinia enterocolitica was isolated from 0.9% of 3795 specimens, ranking as the third most common enteric pathogen.
- Diarrhea (93%) and abdominal pain (72%) were the most frequent symptoms.
- Fourteen patients required hospitalization, and four underwent surgery for suspected appendicitis; acute terminal ileitis and mesenteric lymphadenitis were observed.
- Two HLA-B27 positive patients developed reactive arthritis.
Conclusions:
- Yersinia enterocolitica has emerged as a significant cause of infectious diarrhea in adults.
- The pathogen frequently presents with symptoms mimicking acute appendicitis.
- Reactive arthritis is a potential complication in HLA-B27 positive individuals.
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