Attention: intestinal yersiniosis!

I.I. Nezgoda, O.N. Naumenko

Abstract


The urgency of the intestinal yersiniosis problem is explained by increased incidence of this infection in children. In particular, in Vinnytsia region, the incidence of intestinal yersiniosis in 2017 increased almost 3 times (4.5 per per 100,000 children) compared to the same indicator of 2016 (1.4 per 100,000 children). The polymorphism of clinical symptoms, the difficulties of early diagnosis led to the development of severe, generalized forms of infection, especially in young children. The causative agent of yersiniosis is an intracellular Gram-negative microorganism, Y.enterocolitica, which has 31 serotypes. Most isolates belong to serotypes 03 and 09, serotype 03 has a higher enterotoxicity, and 09 — a higher invasiveness. Virulence plasmids carry Y.enterocolitica serotype 03, and due to this, they more often cause generalization of the infectious process. Infection of a person occurs because of consumption of contaminated food stored for a long time in the cold, since high-virulent populations of Yersinia are formed at a low temperature. Due to a variety of clinical symptoms, the multiplicity of damage to the organs and systems, intestinal yersiniosis manifests under the mask of various diseases. The article presents the clinical case of intestinal yersiniosis with fatal outcome. The boy aged 2 years and 2 months was admitted to the infectious hospital on the 10th day of the disease with complaints of fever, hemorrhagic rash, jaundice, edema of face and extremities. Because of atypical manifestations of the initial stage of the infectious process, the child was suspected of having a viral infection with exanthema, and only with the appearance of jaundice and enlargement of the liver and kidneys, the risk of yersinio­sis infection and involvement of respiratory system in the process were suspected. The clinical case presents clinical and laboratory changes in the patient, the results of additional examinations, and also contains a morphological and histological description of the affected organs in autopsy.

Keywords


intestinal yersiniosis; morbility; generalized forms; children

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DOI: https://doi.org/10.22141/2312-413x.6.3.2018.136649

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