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What causes pseudotuberculosis in children: causes, pathogenesis
Last reviewed: 04.07.2025
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Causes of pseudo tuberculosis
The causative agent of pseudo-tuberculosis is a gram-negative rod, in culture it is located in the form of long chains, does not form spores, has a capsule. A distinctive feature of the pathogen is the ability to grow at low temperatures (1-4 °C), the optimal growth temperature is 22-28 °C. According to the surface antigen, 8 serovars are distinguished, each of which can cause disease in humans, but serovars 1 and 3 are more common. It has high invasive qualities, due to which it is able to penetrate the natural barriers of humans and animals, contains endotoxin. It is assumed that endotoxin is represented by a soluble fraction of O-antigen. The possibility of exotoxin formation has been proven.
Pathogenesis of pseudotuberculosis
The pathogen enters the body through the mouth with contaminated food or water (infection phase) and, having overcome the gastric barrier, enters the small intestine, where it penetrates into the enterocytes or intercellular spaces of the intestinal wall (enteric phase). From the intestine, the microorganisms penetrate into the regional mesenteric lymph nodes and cause lymphadenitis (regional infection phase). Massive influx of the pathogen and its toxins from the primary localization sites into the blood leads to the generalization phase of the infection (bacteremia and toxemia). It corresponds to the appearance of clinical symptoms of the disease. Further progression of the process is associated with the fixation of the pathogen by the cells of the reticuloendothelial system mainly in the liver and spleen. In essence, this is the parenchymatous phase.
Epidemiology of pseudo tuberculosis
Extraintestinal yersiniosis (pseudo tuberculosis) is registered in almost all administrative territories of our country. The disease is classified as a zoonotic infection. The source of infection is wild and domestic animals. The pathogen has been found in 60 species of mammals and 29 species of birds. The main reservoir of infection is mouse-like rodents. They infect food products with secretions, in which, when stored in refrigerators and vegetable stores, the pathogen reproduces and accumulates en masse. It is assumed that its reservoirs may be not only rodents and other animals, but also soil, where the microorganism is able to reproduce and survive for a long time. It is also isolated from water, air, fodder, root crops, vegetables, milk, dairy products, containers, kitchen utensils, etc.
The role of humans as a source of infection remains unproven. Infection occurs through the alimentary route when consuming contaminated food (salads, vinaigrettes, fruits, dairy products, water, etc.) that has not been heat-treated. Epidemic outbreaks of varying intensity occur as a result of the spread of the pathogen through food and water; sporadic cases also occur.
Both children and adults are susceptible to pseudo-tuberculosis. Children under 6 months almost never get sick, and those aged 7 months to 1 year rarely get sick, which can be explained by their nutritional characteristics.
Diseases are registered throughout the year, the maximum is in February-March, which is explained by the wider consumption of vegetables and fruits coming from vegetable storage facilities. Infectivity is moderate - 8-20 per 1000 children.