Yersiniosis

Yersiniosis is an acute infectious disease that belongs to eoonoeam. The main way of human infection is alimentary. A sick person does not represent a danger to others.

Etiology, pathogenesis. The causative agent (iersinia) is similar in its properties to the causative agents of plague and pseudotuberculosis. It differs in polymorphism, bipolar coloration, gram-negative, capsules and spores do not form. Can grow at a temperature of 5 g. C. Highly sensitive to levomycetin, tetracyclines, aminoglycosides. Yersinia are divided into 5 biotypes, 10 phagotypes, and 0-antigen for more than 30 serotypes. The 2nd and 4th biotypes, 3rd, 5th, 8th and 9th serotypes are of greatest importance in human pathology. The introduction of the pathogen occurs in the lower parts of the small intestine, the picture of terminal ileitis develops, there may be ulcerous changes. The lymphogenous pathogen reaches meehnterialnyh lymph nodes, there is lymphadenitis with a tendency to abscessing.

Symptoms, course. The incubation period is from 15h to 4 days (usually 1-2 days). The main clinical forms are: 1) gastroenterciliary, 2) appendicular, 3) septic, 4) subclinical. The disease begins acutely. The temperature of the tep increases to 38-40 g. S. Fever lasts up to 5 days, with septic forms, longer. There are symptoms of general intoxication (chills, headache, pain in the muscles, joints). When the gastroenterocolitis form on this background appears cramping pain in the abdomen, more often in the lower sections on the right or in the umbilical region. There may be nausea and vomiting, a stool liquid fetid, up to 10 times a day. There may be an admixture of mucus, there is usually no blood. In contrast to dysentery, there are also no tenesmus, false urges, spasm and soreness of the thyroid colon. When appendicular form, in addition, there are symptoms of appendicitis (sometimes purulent). Leukocytosis to Chb-yue / l; ESR is enhanced. The septic form develops in weakened individuals, proceeds with a fever of the wrong type, there are repeated chills, profuse sweat, enlargement of the liver and spleen, anemia increases, jaundice appears. This form ends lethal.

Yersiniosis must be differentiated from gastroenterocolitis of other etiology (dysentery, salmonellosis, escherichiosis), pseudotuberculosis, appendicitis. The laboratory confirmation of the diagnosis is the isolation of the causative agent (from feces, blood, pus, remotant vermiform appendage) and RNGA.

Treatment. Assign levomitsetin (0.5 g 3-4 times a day), tetracyclines (0.3-0.4 g 4 times a day) for 5-7 days.

For prevention see Salmonella.