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Pseudotuberculosis (Yersinia) Follow-up

  • Author: Asim A Jani, MD, MPH, FACP; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
 
Updated: Nov 25, 2015
 

Further Inpatient Care

Supportive care for patients with Y pseudotuberculosis sepsis includes general hospital acute-level care (intensive medical/surgical care may be needed, although uncommon unless the patient is severely ill) and intravenous fluids, frequent monitoring, serial examinations, radiographic studies, intravenous antibiotics, and treatment of any complicating host- or disease-related factors.

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Inpatient & Outpatient Medications

In outpatient settings or mild inpatient situations, vigilant observation without the use of antibiotics is reasonable. (See Complications, Prognosis.) Y pseudotuberculosis infection is often benign and self-limited.

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Deterrence/Prevention

Food-borne epidemics of Y pseudotuberculosis infection can occur. Contact precautions, especially in the inpatient setting, apply to appropriate barriers (eg, gown, gloves) to exposure to enteric secretions, such as with diarrhea. Avoid ingestion of uncooked meat, contaminated water, or unpasteurized milk. Careful handwashing should follow consumption or handling of chitterlings (pork intestines).

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Complications

Postinfectious sequelae may include arthritis and erythema nodosum. Additionally, severe Y pseudotuberculosis infection may be complicated by formation of coronary aneurysms, septic features associated with iron-overload states, and renal involvement with tubulointerstitial nephritis. Intussusception has also been reported in children.

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Prognosis

Uncomplicated mesenteric lymphadenitis due to Y pseudotuberculosis infection is generally self-limited and commonly does not require antibiotic therapy. Septic forms of Y pseudotuberculosis infection or those associated with systemic manifestations are serious and carry a high mortality rate (often 75% despite antibiotic therapy).

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Patient Education

Patients with Y pseudotuberculosis infection (and their families) should be familiar with forms of exposure, routes of infection, variable manifestations of the disease, difficulties in the diagnostic issues, and the potential for associated complications, including sepsis, reactive arthritis, erythema nodosum, and rare events such as cardiac or renal sequelae.

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Contributor Information and Disclosures
Author

Asim A Jani, MD, MPH, FACP Clinician-Educator and Epidemiologist, Consultant and Senior Physician, Florida Department of Health; Diplomate, Infectious Diseases, Internal Medicine and Preventive Medicine

Asim A Jani, MD, MPH, FACP is a member of the following medical societies: American Association of Public Health Physicians, American College of Physicians, American College of Preventive Medicine, American Medical Association, American Public Health Association, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Paul Chen University of Texas Southwestern Medical School

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

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