eMedicine Specialties > Infectious Diseases > Bacterial Infections

Yersinia Enterocolitica: Follow-up

Author: Zartash Zafar Khan, MD, Fellow in Infectious Diseases, University of Oklahoma Health Science Center
Coauthor(s): Michelle R Salvaggio, MD, Assistant Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine; Medical Director of Infectious Diseases Institute, University of Oklahoma Health Sciences Center; Mark H Johnston, MD, Associate Professor of Medicine, Uniformed Services University of Health Sciences; Consulting Staff, Lancaster Gastroenterology Inc; Gregory J Martin, MD, Director, Infectious Diseases Clinical Research Program (IDCRP) Associate Professor of Medicine, Uniformed Services University, Bethesda, MD
Contributor Information and Disclosures

Updated: Apr 9, 2009

Follow-up

Further Inpatient Care

  • Admit patients with evidence of severe dehydration, malnourishment, or septicemia.
  • Carefully monitor patients who are immunocompromised or patients with conditions that place them at risk for septicemia (eg, alcoholism, cirrhosis, iron overload syndromes, conditions that require deferoxamine therapy, diabetes, malnourishment), using a low threshold for admission and treatment with supportive measures and antibiotic therapy.

Inpatient & Outpatient Medications

  • Yersiniosis has been treated successfully with antibiotics.
  • Avoid antidiarrheal medications.

Deterrence/Prevention

  • Instruct patients and at-risk individuals about appropriate hygiene methods and signs and symptoms of infection.
  • Encourage public awareness of Y enterocolitica outbreaks and modes of transmission.
  • Hand washing and control of environmental cross-contamination are principal measures in reducing the spread of enteric pathogens in daycares, health care setting, pet care facilities, and within households.
  • In blood banks, donors should be inquired about any recent symptoms of gastroenteritis.
  • Unwashed raw vegetables, uncooked meats (especially pork), and unpasteurized milk should be avoided.

Complications

  • Y enterocolitica infection carries a low mortality rate, but patients with significant comorbidities are at risk of bacteremia, with a reported case fatality rate approaching 50%.
  • Reactive arthritis can last 1-4 months.

Prognosis

  • Yersiniosis is usually either self-limited or is responsive to therapy; however, reinfection is possible.
  • Septicemia is rare but does carry a substantial case fatality rate.

Patient Education

  • Educate patients and individuals at risk of infection about appropriate hygiene methods and signs or symptoms of infection.
  • Encourage public awareness of outbreaks, modes of transmission, and ways to prevent transmission.

Miscellaneous

Medicolegal Pitfalls

  • Exercise caution in differentiating yersiniosis from inflammatory bowel disease, specifically Crohn disease. Performing stool cultures and ruling out infectious etiologies prior to initiating immunomodulatory therapy for inflammatory bowel disease should be a general practice.

Special Concerns

  • Patients with conditions that place them at risk for Y enterocolitica septicemia (eg, elderly patients, patients who are chronically ill, patients with iron overload, patients with chronic hemolysis, patients on deferoxamine therapy, patients who are immunocompromised) should be monitored closely and admitted for antibiotic therapy at the first sign of disseminated disease.
  • In the event of acute outbreaks, attempt to isolate persons who have been in contact with the index patient.
 
Acknowledgments

This article was reviewed by Michelle R. Salvaggio, MD, FACP, Assistant Professor, Associate Fellowship Director of Infectious Diseases, University of Oklahoma Health Science Center.

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Brooks D Cash, MD, FACP, to the development and writing of this article.



More on Yersinia Enterocolitica

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Multimedia: Yersinia Enterocolitica
References
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Further Reading

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Keywords

Yersinia enterocolitica, Y enterocolitica, Yersinia enterocolitis, yersiniosis, acute bacterial gastroenteritis, bacterial gastroenteritis, gastroenteritis, food poisoning, food contamination, water contamination, mesenteric adenitis, enterocolitis

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Contributor Information and Disclosures

Author

Zartash Zafar Khan, MD, Fellow in Infectious Diseases, University of Oklahoma Health Science Center
Zartash Zafar Khan, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, and International Society for Infectious Diseases
Disclosure: Nothing to disclose.

Coauthor(s)

Michelle R Salvaggio, MD, Assistant Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine; Medical Director of Infectious Diseases Institute, University of Oklahoma Health Sciences Center
Michelle R Salvaggio, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Merck Honoraria Speaking and teaching

Mark H Johnston, MD, Associate Professor of Medicine, Uniformed Services University of Health Sciences; Consulting Staff, Lancaster Gastroenterology Inc
Mark H Johnston, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

Gregory J Martin, MD, Director, Infectious Diseases Clinical Research Program (IDCRP) Associate Professor of Medicine, Uniformed Services University, Bethesda, MD
Gregory J Martin, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Medical Editor

Thomas Herchline, MD, Professor of Medicine, Wright State University Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio
Thomas Herchline, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Richard B Brown, MD, FACP, Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine
Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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