Yersinia - Information for Clinicians
Type of infection
Yersinia is a facultative gram-negative coccobacillus. This family includes Yersinia enterocolitica and Yersinia psuedotuberculosis.
Sources of infection
- Yersinia are found in the intestine and lymphatic tissue of pigs and other mammals.
- Most Yersinia infections come from contaminated food. Raw and undercooked pork are often involved. Infection can result from preparing chitterlings (hog intestines). Other foods and milk have become contaminated and caused outbreaks.
Usual symptoms
- Incubation period is 4-6 days.
- Diarrhea, vomiting, and fever are prominent. Abdominal pain is less common.
- Diarrhea can have mucous or blood.
Treatment
- Prevent and treat dehydration.
- Most people will get better without antibiotics. There are no data demonstrating a benefit of antibiotic therapy in uncomplicated Y. enterocolitica gastroenteritis.
- For more severe illnesses, mesenteric adenitis, or extraintestinal infections, treatment is indicated. Antibiotic resistance is variable. For gastrointestinal infections, ciprofloxacin or alternatively, trimethoprim sulfamethoxazole are recommended for empiric therapy. A third generation cephalosporin plus gentamicin can be used for empiric therapy of extraintestinal infections.
Complications
- Dehydration can occur.
- Yersinia can cause symptoms that resemble appendicitis. Severe abdominal complications are rare but include: mesenteric adenitis, peritonitis, perforation, toxic megacolon, and cholangitis.
- Extraintestinal infections can occur and include: bacteremia, hepatic, splenic, or renal abscesses, endocarditis, septic arthritis, osteomyelitis, or meningitis.
- Upon recovery, patients may develop reactive arthritis or erythema nodosum.
Comments
- To prevent Yersinia, avoid raw or undercooked pork. Do not let other food contact raw or undercooked pork.
- Wash hands immediately after handling uncooked meat.