Introduction:
It is a bacterial infection that is caused by Y. pseudotuberculosis. It is also called Yersinia. This infection can be seen to occur worldwide, but it is more common as a sporadic disease, especially in northern Europe and Asia. It is primarily seen to affect rabbits and other mammals and birds. This infection can be transmitted from asymptomatically infected domestic pork, cattle, sheep, deer, and rabbits, dogs, birds, and reptiles and can be transmitted by cross-contamination happening during the preparation of food.
Reports show that many outbreaks of this type of infection have occurred in zoos, laboratory facilities, and animal-holding areas. Y. pseudotuberculosis is a relatively rare pathogen in humans. The Public health data provided by Russia reports this infection since 1988, and children are twelve times more likely to get infected than adults.
The most commonly occurring syndromes related to this bacteria are self-limited enterocolitis and mesenteric lymphadenitis (pseudoappendicitis), but immunocompromised hosts may have septicemia, which may lead to metastatic infection. Commonly seen metastatic sites are liver, spleen, lungs, and joints or bone, especially in individuals who have cirrhosis, diabetes, and hemochromatosis. There is a special form of Y. pseudotuberculosis infection known as Far East scarlet-like fever (FESLF), which has been reported in association with specific strains of Y. pseudotuberculosis, and it is seen in Russia and Japan. It demonstrates mitogen A, which plays the role of a superantigen. In Japan, FESLF is called Izumi fever.
How Is It Caused?
It is caused due to the pathogen Yersinia pseudotuberculosis is a bacteria belonging to the family Enterobacteriaceae, which is most commonly known to cause foodborne illnesses like enterocolitis or mesenteric lymphadenitis (pseudoappendicitis) in children. It can also be associated with complications after the infection like erythema nodosum and reactive arthritis. Reports show that strains of Y. pseudotuberculosis which is found in Asia, can produce a superantigen-associated toxic erythema illness which is suggestive of scarlet fever.
It was first isolated in 1883 and is a gram-negative bacteria belonging to the genus Yersinia in the Enterobacteriaceae family. It can cause gastrointestinal infection in many wild and domestic animals when combined with Yersinia enterocolitica. Y. pseudotuberculosis is cold-tolerant, which leads to the transmission through contaminated cold-stored foods, handling infected animal tissues, and cross-contamination during the preparation of food.
Epidemiology:
-
Mortality/Morbidity - Most of the infections are self-limited and have a low case-fatality rate. The mortality rate can be increased in the septicemic variant more commonly occurring in immunocompromised patients.
-
Race - There is no specific racial or ethnic predilection of this infection.
-
Sex - This infection can be more commonly seen in men than in women. However, women are more prone to develop post infections.
-
Age - Most commonly, it affects children between 5-15 years old.
What Are The Symptoms?
Symptoms of Yersinia pseudotuberculosis are as follows:
-
Pain in the abdomen, which is common on the lower right side and may mimic appendicitis
-
Fever
-
Diarrhea occasionally.
-
Rashes and pain in the joints, which can be seen to appear after 1-3 weeks of the onset of the infection. The joint pain can even last up to 6 months after the infection.
-
People with a weak immune system may develop sepsis which means the spread of infection in the blood.
The symptoms of its other variant can differ between younger children and older children and adults. The symptoms for children under 5 years of age are as follows:
-
Diarrhea
-
Fever
-
Vomiting
-
Abdominal pain in some cases.
Abdominal pain is a prominent symptom in older children and adults. Bacteremia and sepsis are known to occur in patients with a weak immune system.
When To Consult A Doctor?
Pseudotuberculosis is not usually serious, and the recovery is very quick in most people. Anyone who is having prolonged or severe diarrhea or with any of the symptoms mentioned above should visit a doctor. Also, children having diarrhea, vomiting, or refusing to consume fluids should consult a physician.
Are There Any Complications?
This infection can lead to a certain complication, especially in immunocompromised individuals, which are as follows:
· Reactive arthritis
· Bacteremia
How Can It Be Diagnosed?
When you visit your doctor, you will be first asked about various symptoms that you are facing and your diet history. After that, a physical examination will be done, and various lab tests will be conducted. Blood culture and stool culture can be done. Even serological studies can be done to identify the organism.
How Can It Be Treated?
This infection can be treated using various antibiotics, which are as follows:
1. Fluoroquinolones: These are the drugs of choice for this infection. Studies show that they are very effective in treating pseudotuberculosis. Trimethoprim-sulfamethoxazole and aminoglycosides can also be preferred in treating it.
2. B-lactams can be used, but they are questionable. Hence, your physician will decide the treatment regimen depending on the patient and the bacterial strain isolated using various tests.
3. Consumption of more fluids in case of loose motions or diarrhea, or vomiting.
How Can It Be Prevented?
Certain precautions and measures can be taken to prevent this infection which has been mentioned below:
1. Washing fresh fruits and vegetables before consuming them.
2. Avoiding the consumption of raw or undercooked meat.
3. It is advisable to consume only pasteurized milk or milk products.
4. You should wash hands with soap and water:
· Before eating
· Before preparing the food
· After any animal contact
· After using the toilet
· After nappies have been changed
· After you have handled raw meat.
5. You can prevent cross-contamination from occurring in the kitchen by:
· Usage of separate cutting boards for meat and other foods
· Cleaning the kitchen and all the utensils after handling and preparing the meat.
6. The animal feces should be disposed of in a sanitary manner.
Conclusion:
Yersinia or pseudotuberculosis is a bacterial infection that can be managed easily, but if it is not treated on time, it can cause certain complications in the patients, especially in immunocompromised patients. Hence, it is advisable to contact your physician as soon as you suspect or develop any symptoms. Online medical platforms are playing a vital role in decreasing the gap between patients and doctors. Therefore, you can consult a physician or specialist using these platforms to get more details on these infections at the ease of your home.