Yersinia enterocolitica Prosthetic Joint Septic Arthritis Successfully Treated with Ceftriaxone

Yersinia enterocolitica is a Gram-negative coccobacillus that is known to cause gastroenteritis and symptoms mimicking appendicitis or terminal ileitis. It is also one of the culprit infections implicated in causing reactive arthritis. Rarely, it can cause musculoskeletal infections including osteomyelitis, septic arthritis, and discitis. We describe the case of a 70-year-old female with multiple comorbidities who presented with left knee pain and swelling after recent gastroenteritis. She was found to have Yersinia enterocolitica septic arthritis in her left knee prosthetic joint. The patient underwent an exchange of her prosthetic material and was successfully treated with a six-week course of ceftriaxone. Our article aims to highlight a rare manifestation of Yersinia enterocolitica infection and to point out an important differential for reactive arthritis after Yersinia enterocolitica infection.

Spontaneous outbreak of Yersinia enterocolitica infection and co-infection with Escherichia coli in black-tufted marmosets (Callithrix penicillata)

Yersiniosis is a zoonotic bacterial disease that affects humans and animals, including primates. The aim of the study was to report one case of fatal Yersinia enterocolitica infection and two cases of co-infection with Escherichia coli in captive black tufted marmosets (Callithrix penicillata) in Apucarana, Paraná, south Brazil. The affected animals presented severe diarrhea and progressed to death. Gross examination showed multifocal to coalescing necrosis in the liver, mild diffuse hepatomegaly, mild diffuse necrotizing enteritis, moderate splenomegaly and focally extensive hyperemia of the leptomeninges. Microscopically, the liver lesions comprised multifocal areas of lytic necrosis with intralesional colonies of gram-negative coccobacilli, characterizing a severe, random, multifocal to coalescing necrotizing hepatitis. A moderate multifocal lymphocytic cholangiohepatitis, severe focally extensive mucosal necrosis in the small intestine, and mild multifocal lymphoplasmacytic leptomeningitis in the brain were observed. Two cases of co-infection by Y. enterocolitica and E. coli, and one case by Y. enterocolitica were confirmed through bacterial culture, biochemical characteristics and 16S rRNA. To the best of the author’s knowledge, it is the first report of an infection of Y. enterocolitica and co-infection with E. coli in black-tufted marmosets resulting in diarrhea, septicemia and death.

Yersinia enterocolitica Infection in Patients Undergoing Intermittent Hemodialysis

End-stage renal disease is the last stage of chronic kidney disease and affects more than 2 million patients worldwide. The infection-related hospitalization is an important cause of excess morbidity and mortality in this group of patients. Yersinia enterocolitica (YE) is one of the bacteria that hemodialysis (HD) patients can occasionally be infected with. The most common symptoms are fever and mild diarrhea, which is self-limited. However, in HD patients, especially in iron overloaded cases, severe watery or bloody diarrhea can occur. The consumption of undercooked food by patients should sensitize the physician to the possibility of YE infection. Clinically, YE is difficult to diagnose due to nonspecific symptoms and the relatively low prevalence of yersiniosis, compared to other causative pathogens in dialysis patients. There is little information about yersiniosis in HD patients. For this reason, this review aims to summarize the current knowledge on YE infection in HD patients, with the main objective of expounding the problems in identifying, diagnosing, and treating yersiniosis in HD patients.

Associations of Yersinia enterocolitica infection with autoimmune thyroid diseases: a systematic review and meta-analysis

Introduction: Yersinia enterocolitica infection is reportedly associated with the development of autoimmune thyroid diseases (AITD). However, evidence that such infection can lead to AITD is controversial. Thus, this study was aimed to investigate the associations of Y. enterocolitica infection with AITD. Methods: A meta-analysis was performed using PubMed, Web of Science, Embase and Cochrane library to identify relevant studies. The odds ratios (OR) and associated 95% confidence intervals [CI] were obtained. Data were analyzed by STATA 13.0 (Stata Corporation, College Station, TX, USA). Results: Of 215 articles identified, 8 studies with a total of 1490 participants met the criteria and were included in the metaanalysis. There was a significant association between Y. enterocolitica positivity and AITD (OR: 4.31 [CI 95%: 1.81– 10.07], P-value: 0.00). According to the subgroup analysis, Y. enterocolitica infection statistically increased the risk of graves' disease (GD) (OR: 6.12, [CI 95%: 3.71-10.10], P-value: 0.00). Likewise, the pooled OR of association between Y. enterocolitica positivity and hashimoto’s thyroiditis (HT) was 2.84 (CI 95%: 0.71-11.25, P-value: 0.1). Conclusions: The current studies suggest that Y. enterocolitica may be associated with the development of AITD. Further study is needed to explore the underlying mechanisms.