Intestinal (intraintestinal) yersiniosis in children

Intestinal yersiniosis is an acute infectious disease from the group of anthro-pozoonoses with symptoms of intoxication and a primary lesion of the gastrointestinal tract, liver, joints, and less often other organs.

A04.6 Enteritis caused by Yersinia enterocolitica.

Epidemiology

Y. Enterocolitica is widely distributed in nature. Infected animals serve as healthy carriers. Strains isolated from pigs, cows, dogs, cats, and synanthropic rodents, according to biochemical and serological properties, are similar to strains isolated from humans. Especially often, pathogens are found in mouse-like rodents, cattle, pigs, dogs, cats, is released from dairy products, ice cream.

The source of infection can be man and animals, sick or carriers. Infection of a person occurs mainly through infected food, as well as by a contact route. The causative agent is transmitted from person to person through hands, dishes, care items. An aerogenic route of infection can also be possible.

In children's organized groups observed outbreaks of diseases associated with a single source of nutrition. They mark family and intra-hospital outbreaks, in which the most likely source of infection is a patient in an acute period or convalescent. The interval between individual diseases during such outbreaks is from several days to 3 weeks.

Diseases are recorded all year round, but a distinct increase in incidence (outbreaks) is observed from October to May with a peak in November and a decline in July-August. Iersiniosis affects mainly children aged 3 to 5 years.

Classification

According to the prevalence of a symptom or syndrome in the clinical picture, the gastrointestinal abdominal (pseudoapendicular, or right-iliac syndrome, hepatitis), septic, articular, erythema nodosum is isolated.

Causes of intestinal (intra-intestinal) yersiniosis

The causative agent of intestinal yersiniosis is a short Gram-negative rod, mobile at a temperature of +4 to -28 ° C, fixed at 37 ° C. Facultative aerobic, not encapsulated, does not form a spore. It is unpretentious to nutrient media, it grows well at low temperatures. According to biochemical properties, strains of Y. Enterocolitica are divided into five biovars. In humans, biovars III and IV are more often found, rarely - II. More than 30 serovars have been identified for O-antigen. The predominance of individual serovars in certain areas was noted. The microorganism has antigenic kinship with salmonella, and strains of the serovar 09 - with brucella.

What causes intestinal yersiniosis?

Symptoms of intestinal (intra-intestinal) yersiniosis

In the gastrointestinal form, clinical manifestations are similar to intestinal infections of another etiology. The disease begins more often acute, with a rise in body temperature to 38-39 ° C, symptoms of intoxication are expressed: lethargy, weakness, decreased appetite, headache, dizziness, often there is nausea, repeated vomiting, abdominal pain. A constant symptom of the disease is diarrhea. The chair is 2-3 times to 15 times a day. Cal is liquefied, often with an admixture of mucus and greens, sometimes of blood. In the coprogram note mucus, polymorphonuclear leukocytes, single red blood cells, a violation of the enzymatic function of the intestine. In the peripheral blood, moderate leukocytosis with a shift of the leukocyte formula to the left, an increase in ESR.

Symptoms of intestinal yersiniosis

Diagnosis of intestinal (intra-intestinal) yersiniosis

Of the clinical symptoms, the most important is the lesion of the gastrointestinal tract (diarrhea) followed by the appearance of a polymorphous rash in the patient, mainly on the hands, feet, around the joints, enlargement of the liver, spleen, arthralgia, nodular eruptions and other characteristic signs of the disease (prolonged fever, changes in the kidneys, heart , peripheral blood, etc.).

Diagnosis of intestinal yersiniosis

Treatment of intestinal (intra-intestinal) yersiniosis

Of the means of etiotropic therapy, preference is given to left-handed succinic sodium succinate and cephalosporins of III and IV generations.

In moderate and severe forms, in addition to antibiotic therapy, prescribe symptomatic therapy, including detoxification (1.5% reamberin solution), rehydration measures, antihistamines, vitamins, diet.

Treatment of intestinal yersiniosis

Prevention of intestinal (intra-intestinal) yersiniosis

The same. As with intestinal infections of another etiology. No less important are those preventive measures that are performed with pseudotuberculosis.

[1], [2], [3], [4], [5], [6], [7]