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What causes intestinal yersiniosis?
Last reviewed: 06.07.2025
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Causes of intestinal (intra-intestinal) yersiniosis
The causative agent of intestinal yersiniosis is a short gram-negative rod, mobile at temperatures from +4 to -28 °C, immobile at 37 °C. Facultative aerobe, not encapsulated, does not form spores. Undemanding to nutrient media, grows well at low temperatures. According to biochemical properties, Y. enterocolitica strains are divided into five biovars. In humans, biovars III and IV are most often detected, less often - II. More than 30 serovars have been identified by O-antigen. The predominance of individual serovars in certain areas is noted. The microorganism has an antigenic relationship with salmonella, and strains of serovar 09 - with brucellas.
[ Pathogenesis of intestinal (intraintestinal) yersiniosis
The pathogen passes through the stomach, localizes in the small intestine, where it begins to multiply. A particularly common localization is the transition from the small intestine to the cecum (the terminal section of the small intestine, appendix). Possessing enterotoxigenic and invasive properties, Y. enterocolitica penetrates and destroys the epithelial cells of the intestinal mucosa. The inflammatory process can be different - from catarrhal to ulcerative-necrotic. The duration of the inflammatory process also varies. The infection spreads to regional lymph nodes, which enlarge as a result of hyperplasia of lymphoid tissue. Necrotic foci or microabscesses can form in them. The liver and pancreas can be involved in the process.
At this enteral or regional stage the disease may end. In more severe cases, microorganisms may break through into the bloodstream, which leads to generalization of the infection and the development of abscesses of the liver, spleen, lungs, and bones.
The pathogen can persist in the lymph nodes for a long time, causing repeated waves of the disease or transition to a chronic form. Various infectious and allergic manifestations in yersiniosis - exanthema, poly- and monoarthritis, arthralgia, myalgia, tendovaginitis, myositis, heart damage, nodular and other erythema, Reiter's syndrome - some authors explain by the similarity of the structure of the Y. enterocolitica antigen and the histocompatibility antigen HLA B-27, which is found in 90% of such patients compared to 14% in the general population.