Intestinal yersiniosis symptoms

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.

In severe cases, children of an early age can have a picture of intestinal toxicosis and exsicosis, symptoms of irritation of the meninges. At the height of clinical manifestations, the stomach is moderately inflated. When palpation, tenderness and rumbling along the bowels, especially in the region of the blind and ileum, are noted. Sometimes the liver and spleen are enlarged. In some patients, a polymorphic rash appears on the skin (spot, spotted-papular, hemorrhagic) with a favorite localization around the joints, on the hands, feet (symptoms of gloves, socks). In some cases, inflammatory changes occur in the joints (swelling, redness, soreness and restriction of movement), the phenomenon of myocarditis.

Pseudo-pendicular form, or right-iliac syndrome, occurs mainly in children older than 5 years. A constant and leading sign of the disease is a pain in the abdomen, which is often cramped, localized around the navel or in the right ileal region. When palpation is determined rumbling along the course of the small intestine, spilled or local tenderness in the right ileal region, sometimes symptoms of irritation of the peritoneum are noted. There may be short-term diarrhea or constipation, flying pains in the joints, lung catarrh of the upper respiratory tract. In the blood leukocytosis (8-25x10 ⁹ / l) with a shift of the leukocyte formula to the left, increased ESR (10-40 mm / h). During surgery for an acute abdomen, catarrhal or gangrenous appendicitis is sometimes found, and more often mesadenitis (an increase in mesenteric lymph nodes), edema and inflammation of the terminal ileum. In cultures from the distant vermiform appendage, Y. Enterocolitica is found.

Septic (generalized) form of intestinal yersiniosis is rare. Isolate acute and subacute septicemia.

Yersiniosis hepatitis begins acutely, with pronounced signs of intoxication, high body temperature, not decreasing in icteric period, increased ESR. Sometimes there is a short-term diarrhea, abdominal pain. In some patients in the early period from the onset of the disease appears exanthema of a different nature. On the 3-5th day of the disease, dark urine, discolored feces and jaundice are noted. The liver is enlarged, compacted and painful. The edge of the spleen is palpable. The clinical picture is very similar to viral hepatitis. Without additional methods of examination, diagnosis is difficult. It should be borne in mind that with yersiniosis hepatitis, the activity of liver enzymes is low or even normal.

Nodal erythema (nodosa) occurs mainly in children older than 10 years. On the shins appear rashes in the form of painful pink nodes with a cyanotic hue, which disappear after 2-3 weeks, than they differ from the erythema of rheumatic etiology, which lasts longer. In half of patients with erythema nodosum, it is possible to establish a previous gastroenteritis, abdominal pain, sometimes changes in the upper respiratory tract.

The articular form of intestinal yersiniosis proceeds according to the type of non-pristine polyarthritis and arthralgia. Observe it rarely, mainly in children older than 10 years. 5-20 days before the appearance of arthritis, children are noted intestinal disorders, accompanied by fever. More often the knee and elbow joints are involved in the process, less often the small joints of the hands and feet. The joints are painful, swollen, the skin over them is hyperemic. When X-ray examination of the affected joints in the acute phase of the disease, no pathological changes are detected.

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