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A pediatric case highlights Yersinia enterocolitica as a cause of inflammatory colitis. Early suspicion is crucial for diagnosing this infectious colitis, often mistaken for Crohn's disease or ulcerative colitis.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Investigating acute febrile diarrhea in children.
- Differentiating inflammatory colitis from other pediatric gastrointestinal disorders.
- Challenges in identifying bacterial pathogens in pediatric diarrhea.
Observation:
- A 2-year-old presented with acute febrile, non-bloody diarrhea and inflammatory colitis on sigmoidoscopy and radiography.
- Initial stool and blood cultures were negative for common bacterial pathogens.
- Diagnostic perseverance led to a positive stool culture for Yersinia enterocolitica.
Findings:
- Confirmed diagnosis of infectious colitis caused by Yersinia enterocolitica.
- Serologic studies and clinical course supported the Yersinia enterocolitica diagnosis.
- Radiographic findings mimicked inflammatory bowel disease.
Implications:
- Yersinia enterocolitica should be considered in the differential diagnosis of pediatric inflammatory colitis.
- Highlights the importance of considering Yersinia in radiographic differentials for Crohn's disease and ulcerative colitis.
- Emphasizes the need for diagnostic consideration of Yersinia enterocolitica in intractable childhood diarrhea.
Abstract:
A 2-year-old child with a febrile, non-bloody diarrheal illness of acute onset with repeatedly negative stool and blood cultures for pathogenic bacteria is presented. Sigmoidoscopic and roentgenographic studies revealed an inflammatory colitis. Unfortunately, diagnostic perserverance and a high index of suspicion resulted in a positive stool culture for Yersinia enterocolitica. Serologic study and clinical course provided data consistent with the diagnosis of an infectious colitis due to Yersinia enterocolitica. This case demonstrates the necessity to consider Yersinia enterocolitica in the radiographic differential diagnosis of Crohn's disease of the colon or ulcerative colitis, as well as intractable diarrhea of childhood.