yersiniosis
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Yersiniosis is an
infectious disease An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
of the
gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...
caused by
bacteria Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of Prokaryote, prokaryotic microorganisms. Typically a few micr ...
of the genus '' Yersinia'' other than '' Y. pestis''. Most cases of yersiniosis in humans are caused by '' Y. enterocolitica'', with a small minority being caused by '' Y. pseudotuberculosis''. Rarely, other species of the genus can cause yersiniosis. Yersiniosis most frequently affects young children. The infection is thought to be contracted through the consumption of undercooked meat products, unpasteurized milk, or water contaminated by the bacteria. It has been also sometimes associated with handling raw chitterlings. However, most cases of yersiniosis lack a clear source, and are considered sporadic. ''Y. pestis'' is not considered to be a causative agent of yersiniosis because it is the organism that causes Plague, which is considered to be a distinct disease.


Signs and symptoms

Infection with ''Y. enterocolitica'' can cause a variety of symptoms depending on the age of the person infected. Common symptoms include: *
Fever Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, s ...
* Abdominal pain * Diarrhea (typically bloody) *
Vomiting Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pre ...
Symptoms typically develop 4 to 7 days after exposure and may last 1 to 3 weeks or longer. In older children and adults, right-sided abdominal pain and fever may be the predominant symptoms, and may be confused with
appendicitis Appendicitis is inflammation of the Appendix (anatomy), appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and anorexia (symptom), decreased appetite. However, approximately 40% of people do not have these t ...
. In a small proportion of cases, complications such as skin rash, joint pains, ileitis, erythema nodosum, and sometimes
sepsis Sepsis is a potentially life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage of sepsis is followed by suppression of the immune system. Common signs and s ...
, acute arthritis or the spread of bacteria to the bloodstream (
bacteremia Bloodstream infections (BSIs) are infections of blood caused by blood-borne pathogens. The detection of microbes in the blood (most commonly accomplished by blood cultures) is always abnormal. A bloodstream infection is different from sepsis, wh ...
) can occur.


Transmission

The natural
reservoir A reservoir (; ) is an enlarged lake behind a dam, usually built to water storage, store fresh water, often doubling for hydroelectric power generation. Reservoirs are created by controlling a watercourse that drains an existing body of wa ...
animals for ''Y. enterocolitica'' are swine, including domesticated pigs and wild boars. Most cases of human yersiniosis are thought to be due to either consumption of undercooked meat from pigs, or poor
sanitation Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems ...
allowing fecal matter or blood of pigs to contaminate objects and food items near them. Because of the frequency of associations between human and pig strains of yersiniosis, it is often referred to as a zoonotic disease.


Diagnosis

Most diagnoses of yersiniosis are made via
ELISA The enzyme-linked immunosorbent assay (ELISA) (, ) is a commonly used analytical biochemistry assay, first described by Eva Engvall and Peter Perlmann in 1971. The assay is a solid-phase type of enzyme immunoassay (EIA) to detect the presence of ...
immunoassay testing. However, in locations without access to this form of testing, traditional bacterial cultures may be created and then biochemically tested. Many cases of yersiniosis are initially misdiagnosed as
appendicitis Appendicitis is inflammation of the Appendix (anatomy), appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and anorexia (symptom), decreased appetite. However, approximately 40% of people do not have these t ...
, which is much more common and may present with similar symptoms.


Treatment

Treatment for gastroenteritis due to ''Y. enterocolitica'' typically requires only symptomatic treatment of diarrhea with common anti-diarrheal drugs. Severe infections with systemic involvement (sepsis or bacteremia) often requires aggressive antibiotic therapy; the drugs of choice are
doxycycline Doxycycline is a Broad-spectrum antibiotic, broad-spectrum antibiotic of the Tetracycline antibiotics, tetracycline class used in the treatment of infections caused by bacteria and certain parasites. It is used to treat pneumonia, bacterial p ...
and an aminoglycoside. Alternatives include cefotaxime, fluoroquinolones, and co-trimoxazole.Torok E. Oxford MHandbook of Infect Dis and Microbiol, 2009 Standard antibiotics such as
penicillin Penicillins (P, PCN or PEN) are a group of beta-lactam antibiotic, β-lactam antibiotics originally obtained from ''Penicillium'' Mold (fungus), moulds, principally ''Penicillium chrysogenum, P. chrysogenum'' and ''Penicillium rubens, P. ru ...
are often ineffective due to the production of beta-lactamase enzymes by ''Yersinia'' species.


See also

* Plague * Enteritis


References


External links

{{Gram-negative bacterial diseases Bacterial diseases