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Yersinia pseudotuberculosis-Associated Myositis.

Koji Yokoyama¹, Mitsukazu Mamada¹

¹Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, JPN.

|December 11, 2024

Summary

A rare case of myositis developed in a child after Yersinia pseudotuberculosis infection. This post-infectious complication resolved with conservative care, highlighting awareness for clinicians.

Keywords:

antibiotics myositis pediatric reactive arthritis treatment yersinia pseudotuberculosis infection

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Area of Science:

Microbiology
Infectious Diseases
Pediatrics

Background:

Yersinia pseudotuberculosis (Y. pstb.) is a Gram-negative bacterium causing gastrointestinal infections like enterocolitis.
While reactive arthritis is a known complication, myositis is an exceptionally rare sequela.

Observation:

A five-year-old boy presented with fever, abdominal pain, and leg pain progressing to severe muscle weakness and inability to walk.
Laboratory tests revealed elevated inflammatory markers, and stool cultures confirmed Y. pseudotuberculosis infection.
MRI demonstrated muscle inflammation indicative of myositis.

Findings:

The patient experienced rapid improvement with conservative management, including rest and acetaminophen, without antibiotic intervention.
He remained asymptomatic 13 years post-infection, suggesting a favorable long-term prognosis.
This case documents the extremely rare occurrence of myositis following Y. pseudotuberculosis infection.

Implications:

The findings suggest a potential post-infectious, immune-mediated mechanism for myositis development after Y. pseudotuberculosis.
Clinicians should consider myositis in the differential diagnosis for children with muscle weakness following Y. pseudotuberculosis infection.
Conservative treatment approaches may be sufficient for managing this rare complication.