How does infection occur?
Yersinia lives in the intestines of pigs, rodents and other animals and ends up in soil, water and on vegetables. The key feature of the bacterium is its ability to multiply at refrigerator and cellar temperatures, so the danger grows towards the end of winter and spring, when vegetables have been stored for a long time. Most often, infection occurs through salads made from raw cabbage, carrots, beets and greens, less often through unpasteurized milk, undercooked pork and water. Washing vegetables and removing spoiled areas significantly reduces the risk.
- Long-lasting vegetables and salads made from them
- Bacterial growth at refrigerated temperatures
- Unpasteurized milk and dairy products
- Undercooked pork
- Water from unverified sources
- Contact with rodents and their secretions
Forms and symptoms
The disease begins acutely, a few days after infection, with chills and fever. Further, the picture depends on the shape. In the intestinal form, abdominal pain, nausea and loose stools predominate. In abdominal pain, the pain is concentrated in the right iliac region due to inflammation of the lymph nodes of the mesentery and the terminal ileum. Pseudotuberculosis often produces a bright, pinpoint rash with thickening around the joints, as well as the characteristic “hood,” “glove,” and “sock” symptoms—redness of the face, hands, and feet, followed by peeling.
- Fever, chills, headache and muscle pain
- Abdominal pain, usually lower right
- Loose stools, nausea, less often vomiting
- Dotted or patchy rash with thickening at the joints
- Redness and peeling of the palms and feet
- Liver enlargement, sometimes jaundice
- Joint pain and red eyes
Why it is dangerous and how it is distinguished from appendicitis
Mesenteric lymphadenitis with yersiniosis is clinically very similar to acute appendicitis: pain in the lower right, temperature, increased leukocytes. The distinction is made by a surgeon, if necessary with ultrasound, because an error in any direction is dangerous. After an infection, some patients develop reactive arthritis in one to three weeks, less commonly erythema nodosum - painful red nodes on the legs. In people with iron overload, cirrhosis, or diabetes, the infection can be severe, spreading into the blood and forming purulent foci.
- Mesenteric lymphadenitis mimics appendicitis
- Reactive arthritis after intestinal symptoms
- Erythema nodosum on the legs
- Liver damage with elevated enzymes
- Generalized forms due to iron overload and immunodeficiency
- Possible prolonged and recurrent course
Diagnostics
The diagnosis is confirmed by stool culture, and in generalized forms - by blood culture; It is important for the laboratory to indicate that yersiniosis is suspected, since these bacteria require special conditions. Additionally, antibodies to Yersinia are determined, but in the first days of the disease they do not yet have time to appear, so the analysis is sometimes repeated. A general blood test is characterized by leukocytosis, accelerated ESR, and sometimes eosinophilia. Liver enzymes help detect liver damage. An abdominal ultrasound shows enlarged mesenteric lymph nodes and the condition of the liver, and also helps to exclude surgical pathology.
- Stool culture for Yersinia indicating suspicion
- Blood culture for high fever
- Antibodies to Yersinia in dynamics
- Complete blood count, ESR, C-reactive protein
- ALT, AST, bilirubin
- Ultrasound of the abdominal cavity and mesenteric lymph nodes
Treatment and prevention
Mild intestinal forms are treated as a normal intestinal infection: replenishment of fluids and salts, gentle nutrition, rest. For moderate and severe cases, fever, liver and joint damage, as well as generalized forms, the doctor prescribes an antibiotic taking into account the sensitivity of the pathogen; It is important to complete the course, otherwise the disease may return. For reactive arthritis, anti-inflammatory drugs are added. Prevention is simple and reliable: thoroughly wash and peel vegetables, throw away spoiled ones, do not store ready-made salads for a long time and boil milk from unverified sources.
- Rehydration and gentle diet
- Antibiotic as prescribed by a doctor, full course
- Anti-inflammatory drugs for arthritis
- Liver enzyme monitoring
- Thorough washing and peeling of vegetables before salad
- Remove spoiled parts of root vegetables
- Do not store prepared salads for longer than 24 hours