Invasive Yersiniosis in a Pediatric Patient With β-Thalassemia Major: Acute Decompensation After Rapid Blood Transfusion

An investigative study on Yersinia enterocolitica in animals, humans and dried milk in New Valley Governorate, Egypt

BACKGROUND

Yersiniosis is one of the most significant intestinal disorders caused by Yersinia enterocolitica and affects both humans and animals. This study aimed to investigate the prevalence of Y. enterocolitica in New Valley Governorate, Egypt in animals, humans, fresh milk and dried milk. Additionally, this study analyzed the presence of virulence genes, including ail and Yst in tested isolates and conducted a phylogenetic analysis to determine the genetic similarity between human, and animal Y. enterocolitica isolates. Finally, the antimicrobial resistance patterns of the isolates were examined.

RESULTS

Among the 982 samples examined, the prevalence of Y. enterocolitica based on ISO10273-2017 was 11.7% in animal samples including 12.8% of animal faeces, and 10.4% in milk samples. Moreover, the prevalence of Y. enterocolitica was 13.2% in human stool, and 9.5% in dried milk samples. The molecular characterization of the six randomly selected isolates showed that the 16S rRNA, ail and Yst genes were found in 50, 33.3 and 100% of the examined Y. enterocolitica isolates, respectively. Phylogenetic analysis of animal and human isolates based on the 16S rRNA gene revealed a high degree of similarity between the isolates. All the tested animal and human Y. enterocolitica isolates (100%) were resistant to ampicillin and cefotaxime, but highly sensitive to norfloxacin.

CONCLUSIONS

The high prevalence of Y. enterocolitica in animal and human samples with high degrees of genetic similarity poses a threat to public and animal health. Animal faeces, milk and milk powder represent the main sources of Y. enterocolitica infection in humans. Additionally, high levels of antibiotic resistance of Y. enterocolitica can cause public health hazards by leading to the failure of disease prevention and treatment programs in humans and animals.

Yersinia Enterocolitis May Mimic Appendicitis: 12 Years of Experience in a Single Tertiary Center

Introduction

Yersinia enterocolitica infection is a zoonotic disease that varies from self-limited gastroenteritis to more severe forms. Its propensity to affect the terminal ileum and to spread to regional lymph nodes explains the potential misdiagnosis with appendicitis.

Methods

We reviewed the Y. enterocoliticainfection cases in a pediatric population for the last 12 years.

Results

There were 11 cases of Y. enterocolitica infection in the selected period. Four patients had a suspected surgical diagnosis: 1 intussusception, 3 acute appendicitis. Patients who presented with appendicitis-like features were older, whereas younger children most commonly presented with diarrhea and fever. Ultrasound and abdominal computed tomography (CT) were performed in appendicitis-like patients and ruled out appendicitis in 2 of the 3 cases. The only patient submitted to surgery had abnormal CT findings and an important risk factor for this infection that was not recognized at presentation.

Conclusion

This condition should be considered in patients with known risk factors (such as iron overload) and with the right epidemiological setting when presenting with abdominal symptoms. The suspicion of this diagnosis in these particular cases might obviate unnecessary surgical interventions.