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Pseudotuberculosis - Complications, Diagnosis, Treatment, and Prevention

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Pseudotuberculosis - Complications, Diagnosis, Treatment, and Prevention

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Pseudotuberculosis is a bacterial infection that is caused by Y. pseudotuberculosis, a gram-negative bacteria. Read about the causes, symptoms, risk factors, and treatment now.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At March 1, 2021
Reviewed AtSeptember 11, 2023

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:

· Erythema nodosum

· Reactive arthritis

· Bacteremia

· Septicemia

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.

Frequently Asked Questions

1.

Is It Possible to Treat Pseudotuberculosis?

Pseudotuberculosis is treatable with various groups of antibiotics. Fluoroquinolones are effective in treating pseudotuberculosis. Other medications include Aminoglycosides and Trimethoprim-Sulfamethoxazole. The effectiveness of beta-lactam antibiotics has yet to be discovered. The fatality rate for patients treated with Penicillins and first- and second-generation Cephalosporins appeared slightly higher than those treated with Fluoroquinolones, Aminoglycosides, and Trimethoprim-Sulfamethoxazole.

2.

What Types of Antibiotics Are Used to Treat Pseudotuberculosis?

Antibiotics used in treating pseudotuberculosis include Fluoroquinolones, Aminoglycosides, Ciproflaxcin, Ceftriaxone, Gentamycin, Doxycycline, and Trimethoprim-sulfamethoxazole. Fluoroquinolones are effective drugs in treating this condition. However, the use of beta-lactam antibiotics still needs to be clarified.

3.

What Can Be Done to Prevent Yersinia Pseudotuberculosis?

Some steps to prevent the spread of the infection are as follows:
a) After using the restroom, changing a baby's diaper, and before handling or consuming any food, wash your hands.
b) To lessen the chance of infection transmission, ensure people with diarrhea, especially kids, wash their hands thoroughly and regularly with soap.
c) After handling farm animals, domestic animals, pets, animal waste, or animal habitats, always wash your hands.
d) Cook raw meat and poultry completely to get rid of the bacteria.
e) Cook meat, chicken, pig, and hamburgers until the center are no longer pink.

4.

What Is the Most Common Clinical Form of Pseudotuberculosis?

Self-limited enterocolitis and mesenteric lymphadenitis, which mimics appendicitis, are the two most typical clinical Y pseudotuberculosis syndromes. Still, immunocompromised hosts are susceptible to septicemia, which can lead to metastatic infection. The symptoms include abdominal pain, fever, vomiting, and diarrhea.

5.

What Are the Modes of Pseudotuberculosis Transmission?

It spreads between animals through the fecal-oral pathway. Humans become sick when they consume fresh fruit contaminated with animal excrement, diseased meats, particularly pork, and unpasteurized milk or polluted water. These can be avoided by following the preventive steps that are mentioned above.

6.

What Illness Is Caused by Corynebacterium Pseudotuberculosis?

The infection Corynebacterium pseudotuberculosis is well known to affect farm animals, primarily sheep and goats. Infection in humans happens infrequently. However, it results in ulcerative lymphangitis (inflammation of lymph vessels), abscesses in horses, and caseous lymphadenitis in sheep and goats. Caseous lymphadenitis (CLA) is a chronic infectious illness that causes economic damage in sheep and goat production around the world. Since there is no effective cure for CLA, immunization is the most significant preventive measure.

7.

What Examinations Would You Carry Out to Verify the Diagnosis of Yersinia Pseudotuberculosis?

 - Yersinia pseudotuberculosis infection is typically diagnosed by isolating the organism from stool, tissue, blood, or joint fluid.
 - A trustworthy serologic test for diagnosing Yersinia pseudotuberculosis infection is sodium dodecyl sulfate-polyacrylamide gel electrophoresis.

8.

How Can You Naturally Treat Yersinia Enterocolitica?

Herbs that are used to cure Yersinia include:
 - Oregano leaf or oil.
 - The abundant phenol oil in cloves, known as clove-eugenol, has demonstrated potent antibacterial properties against Yersinia in vitro.
 - Cinnamon.
 - Husk from pomegranate.
 - The guava leaf.
 - Plants that contain berberine.

9.

Does Yersinia Pseudotuberculosis Need Reporting?

Y. pseudotuberculosis was diagnosed initially in the United States in 1938 and has been infrequent since then. No epidemics have been reported; from 1938 to 1973, there were only 14 instances reported. Yersiniosis is a notifiable disease in all Foodborne Diseases Active Surveillance Network (FoodNet) sites, even though it is not reportable nationally.

10.

Does Yersinia Pseudotuberculosis Induce Infective Endocarditis?

Yersinia pseudotuberculosis rarely causes infective endocarditis in some patients. However, due to a lack of experience, managing these infections might take a lot of work. Clinical symptoms included fever, sepsis, and embolic events, followed by cardiac failure. The three antimicrobials that were most frequently utilized were:
 - Aminoglycosides.
 - Cephalosporins.
 - Quinolones.

11.

Is Yersinia Pseudotuberculosis Capable of Fermenting Lactose?

Gram-negative bacilli called Yersinia pseudotuberculosis are non-spore-forming, pleomorphic, non-lactose-fermenting organisms that can grow in aerobic and anaerobic environments. But the bacteria has the ability to ferment glucose.

12.

What Is the Yersinia Incubation Period?

Symptoms usually appear 4 to 7 days after exposure and can persist for up to 3 weeks. Rare complications can include skin rash, joint pain, or bacteria entering the bloodstream.

13.

Is It Possible for Yersinia to Grow On Macconkey Agar?

The yersinia grew best on MacConkey agar and next on SS agar. On MacConkey, SS, EMB, Hektoen, and XLD media, the strains of Y. pseudotuberculosis formed only one type of colony. On the differential media, strains of both Y. enterocolitica and Y. pseudotuberculosis grew better at 35 degrees C than at 22 degrees C, but Y. pseudotuberculosis grew much more slowly than the other species.
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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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pseudotuberculosisbacterial infectionimmunocompromisedscarlet fever
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