Intestinal (intraintestinal) yersiniosis in children

Intestinal yersiniosis is an acute infectious disease from the group of anthropozoonoses with symptoms of intoxication and predominant damage to the gastrointestinal tract, liver, joints, and, less often, other organs.

A04.6 Enteritis due to Yersinia enterocolitica.

Epidemiology

Y. enterocolitica is widespread in nature. Infected animals serve as healthy carriers. Strains isolated from pigs, cows, dogs, cats, synanthropic rodents are similar in biochemical and serological properties to strains isolated from humans. The pathogens are especially often found in mouse-like rodents, cattle, pigs, dogs, cats, and are isolated from dairy products and ice cream.

The source of infection can be humans and animals, sick or carriers. Human infection occurs mainly through contaminated food, as well as by contact. The pathogen is transmitted from person to person through hands, dishes, and care items. Airborne transmission of infection is also possible.

Outbreaks of diseases associated with a single food source are observed in children's organized groups. Family and hospital outbreaks are noted, in which the most likely source of infection is a patient in the acute period or a convalescent. The interval between individual diseases during such outbreaks ranges from several days to 3 weeks.

Diseases are registered all year round, but a clear increase in morbidity (outbreaks) is noted from October to May with a peak in November and a decline in July - August. Yersiniosis mainly affects children aged 3 to 5 years.

Classification

Depending on the prevalence of a symptom or syndrome in the clinical picture of the disease, gastrointestinal-abdominal (pseudoappendicular, or right iliac region syndrome, hepatitis), septic, articular forms, and erythema nodosum are distinguished.

Causes of intestinal (intra-intestinal) yersiniosis

The causative agent of intestinal yersiniosis is a short gram-negative rod, mobile at temperatures from +4 to -28 °C, immobile at 37 °C. Facultative aerobe, not encapsulated, does not form spores. Undemanding to nutrient media, grows well at low temperatures. According to biochemical properties, Y. enterocolitica strains are divided into five biovars. In humans, biovars III and IV are most often detected, less often - II. More than 30 serovars have been identified by O-antigen. The predominance of individual serovars in certain areas is noted. The microorganism has an antigenic relationship with salmonella, and strains of serovar 09 - with brucellas.

What causes intestinal yersiniosis?

Symptoms of intestinal (intraintestinal) yersiniosis

In the gastrointestinal form, clinical manifestations are similar to intestinal infections of other etiologies. The disease often begins acutely, with a rise in body temperature to 38-39 °C, symptoms of intoxication are expressed: lethargy, weakness, loss of appetite, headache, dizziness, nausea, repeated vomiting, abdominal pain are common. A constant symptom of the disease is diarrhea. Stool frequency increases from 2-3 to 15 times a day. Stool is loose, often with an admixture of mucus and greenery, sometimes blood. The coprogram shows mucus, polymorphonuclear leukocytes, single erythrocytes, and a violation of the enzymatic function of the intestine. In the peripheral blood, moderate leukocytosis with a shift in the leukocyte formula to the left, an increase in ESR.

Symptoms of intestinal yersiniosis

Diagnosis of intestinal (intraintestinal) yersiniosis

Of the clinical symptoms, the most significant is damage to the gastrointestinal tract (diarrhea), followed by the appearance of a polymorphic rash in the patient, mainly on the hands, feet, around the joints, enlargement of the liver, spleen, arthralgia, nodular rashes and other characteristic signs of the disease (prolonged fever, changes in the kidneys, heart, peripheral blood, etc.).

Diagnosis of intestinal yersiniosis

Treatment of intestinal (intra-intestinal) yersiniosis

Among the etiotropic therapy agents, preference is given to levocetin sodium succinate and cephalosporins of the third and fourth generations.

In moderate and severe forms, in addition to antibiotic therapy, symptomatic therapy is prescribed, including detoxification (1.5% reamberin solution), rehydration measures, antihistamines, vitamins, and diet.

Treatment of intestinal yersiniosis

Prevention of intestinal (intra-intestinal) yersiniosis

The same as with intestinal infections of other etiologies. Of no less importance are the preventive measures that are carried out with pseudo-tuberculosis.

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