Yersinia enterocolitica
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Yersinia enterocolitica
- Characteristics
- Gram negative coccobacilli
- Requires iron as an essential growth factor
- Most strains lack efficient iron-uptake mechanisms
- Grows in cold temperatures (refrigeration)
- Many virulent strains may be calcium-dependent
- Virulence factors
- Enterotoxin
- Activates guanylate cyclase, increasing cGMP
- Intracellular increase in cGMP leads to watery diarrhea
- Activates guanylate cyclase, increasing cGMP
- Enterotoxin
- Transmission
- Oral ingestion of bacteria
- pet feces
- undercooked pork
- may also appear in contaminated milk
- Oral ingestion of bacteria
- Presentation
- Watery diarrhea
- Invades GI mucosa and releases enterotoxin, causing watery diarrhea
- Pseudoappendicitis
- Right lower abdominal pain due to growth and inflammation in mesenteric lymph nodes
- appendix appears normal on CT
- Watery diarrhea
- Treatment
- Antibiotics are not indicated for uncomplicated diarrhea
- Supportive care (hydration) is standard of care
- Severe cases may warrant antibiotics
- Fluoroquinolones or TMP-SMX
- Cephalosporins and gentamicin also used for sepsis
- Antibiotics are not indicated for uncomplicated diarrhea