Yersinia Enterocolitica Infection in Patients with Acute Surgical Abdominal Disease: A Prospective Study

Abstract

The rate of yersiniosis in patients with acute abdominal disease was studied in a 16-month prospective investigation in 1972-1973 of 205 acutely ill patients referred to a surgical clinic of a Copenhagen City hospital with complaints of abdominal pain suggestive of appendicitis. Yersinia enterocolitica, biotype 4, was isolated from 11 patients (5.4%), 8 of whom were children. Yersinia was grown from faeces in 8 cases and from appendix of all 9 patients operated upon. Rising or falling agglutinin titres larger than or equal to 100, indicative of yersiniosis, were found in 22 patients (10.7%) including all bacteriologically verified cases. Eight additional patients (3.9%) had less significant titres larger than or equal to 100, suggestive of recent or present infection. 28 patients (13.7%) had insignificant titres, including 3 with antibodies against serotype 9. In all cases except these 3, antibodies were against Y. enterocolitica, serotype 3. A differential diagnosis between Y. enterocolitica infection and other types of appendicitis could not be made within this highly selected group of patients using available clinical data. All cases were rather mild and self-limiting. It is suggested that in future epidemiological and other studies of yersiniosis, early bacteriological and serological examinations be carried out.

Clinical manifestations ofYersinia pseudotuberculosis infection in children

“…It has been reported previously that pseudoappendicitis may occur leading to surgery (7,28). In the present study, appendicitis was not found, but the three surgical patients had mesenteric lymphadenitis.…”

Yersiniosis in children.

“…4 However, chronic diarrhoea has also been described.5 In older children Y. enterocolitica infection has often been associated with mesenterial lymphadenitis causing an acute, appendicitis-like disease. 6 It has recently been shown that Y. enterocolitica from human sources is invasive for human epithelial cells in vitro.7-9 We have demonstrated polymorphonuclear leucocytes in the stools of patients with Y. enterocolitica infection, and suggested an association between the invasiveness of the pathogen, clinical exudative diarrhoea, and the presence of faecal leucocytes.9…”

Heat‐Stable Enterotoxin Produced by Yersinia enterocolitica Isolated from Patients

“…Yersinia enterocolitica causes a variety of illnesses in humans, such as gastroenteritis (6), pseudoappendicitis (8), nonsuppurative arthritis (26), septicemia (21), and suppurative infections (20). Gastroenteritis in young children has recently become the most common clinical manifestation (6,12), and several large outbreaks of Y. enterocolitica have been reported from Canada (3), and New York State (4).…”