Yersinia pseudotuberculosis Infection Complicated with Bacteremia in a 10-Month-Old Boy

Area of Science:

• Infectious Diseases
• Pediatrics
• Gastroenterology

Background:

• Yersinia pseudotuberculosis infection is uncommon but can present with symptoms overlapping Kawasaki disease (KD), ileitis, and appendicitis.
• Yersinia pseudotuberculosis-derived mitogen (YPM), a superantigen, contributes to KD-like symptoms.
• Bacteremia complicating Yersinia pseudotuberculosis infection is a rare but serious occurrence.

Observation:

• A 10-month-old boy presented with fever, watery stool, and poor vitality, exhibiting colonic wall thickening and appendix swelling.
• Antibiotic treatment for suspected bacterial enteritis or appendicitis preceded the development of facial rashes and extremity edema.
• The patient displayed 5/6 major symptoms consistent with Kawasaki disease.

Findings:

• Blood and stool cultures confirmed Yersinia pseudotuberculosis infection.
• Antibacterial therapy led to symptom improvement and an increased inflammatory response.
• Post-discharge, the patient exhibited finger desquamation, a characteristic sign of Kawasaki disease.

Implications:

• Yersinia pseudotuberculosis should be considered in the differential diagnosis for Kawasaki disease, terminal ileitis, and appendicitis.
• Understanding Yersinia pseudotuberculosis infection routes and optimizing culture methods are crucial for accurate diagnosis.
• Early recognition and appropriate management of Yersinia pseudotuberculosis are vital, especially in pediatric cases presenting with complex symptoms.