Yersinia enterocolitica enteritis
Introduction
Introduction to Yersinia enteritis in enterocolitis Yersinia enterocolitica is a zoonotic infection caused by Yersinia enterocolitica. The clinical manifestations are mainly acute gastroenteritis, enterocolitis and sepsis. There are also many clinical types of acute appendicitis, meningitis, polyarthritis, scarlet fever, jaundice and lymphocytic leukemia, and some cases have a chronic tendency. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: fecal mouth spread Complications: iridocyclitis choroiditis arteritis hemolytic anemia glomerulonephritis
Cause
Causes of enteritis in Yersinia enterocolitica
(1) Causes of the disease
Yersinia enterocolitica (YE) Enterobacteriaceae, Gram-negative, Brevibacterium ovale, flagellum and pili, easy to grow on ordinary medium at 25-30 ° C, this The bacteria are more resistant in vitro, sensitive to moist heat and chemical disinfectants, and the bacteria are invasive and can also produce heat-resistant enterotoxin, which are related to pathogenicity.
(two) pathogenesis
After the bacteria enter the intestine, the enterotoxin, cytotoxin and invasiveness cause disease. Yersinia enterocolitica first adheres to the lower end of the ileum, the cecum and colon mucosa, and then invades the lamina propria and causes inflammation, forming superficial ulcers, collecting Lymph node enlargement and mesenteric lymphadenitis, the heat-resistant enterotoxin produced by the epithelial cells inhibits the absorption of Na and water by the epithelial cells, causing diarrhea. If the body's resistance is reduced, the bacteria can enter the bloodstream to cause sepsis and migratory lesions. In addition, the bacteria It can also induce autoimmune diseases, which are thought to be related to superantigen activity. After entering the intestine, Y. pseudotuberculosis is often confined to the ileocecal lymph nodes and mesenteric lymph nodes, forming suppurative lymphadenitis and granulomatous lesions, occasionally entering the blood. flow.
Prevention
Prevention of enterocolitis of enterocolitis
Pay attention to food hygiene and avoid contamination of food and drinking water. Refrigerated foods should be heated and boiled before being eaten to avoid contact with patients and sick animals.
Complication
Complications of Yersinia enteritis in enterocolitis Complications iridocyclitis choroiditis aortitis hemolytic anemia glomerulonephritis
Can also be complicated by nodular erythema, iridocyclitis, choroiditis, arteritis, hemolytic anemia and glomerulonephritis.
Symptom
Enterocolitis Yersinia enteritis symptoms Common symptoms Abdominal pain Leukocytosis Diarrhea Hyperthermia Hepatosplemosis Toxic nodules Abscess Joint pain
Clinical manifestations are complex and diverse, and some cases have a chronic tendency.
Intestinal colitis
About 2/3 cases show this type, the incubation period is 4 to 10 days, acute fever, abdominal pain and diarrhea, watery stools, mucus, occasional pus and blood, a few have vomiting, the course of disease is generally several days, can be up to 1 to 2 weeks.
2. Terminal ileitis
The lesions are mainly end-ileal, appendix and mesenteric lymph nodes. The clinical features are sudden fever, right lower quadrant pain or tenderness, diarrhea, and peripheral blood leukopenia.
Septicemia
More common in the elderly or patients with low immunity, persistent high fever, hepatosplenomegaly, headache, abdominal pain, but not necessarily accompanied by diarrhea, some patients have migratory abscess lesions in other parts of the body, peripheral blood leukocytes.
4. Allergic disease
10% to 30% of cases of adult enterocolitis can be secondary to arthritis. After several days of acute diarrhea, multiple joint pains and even swelling occur. After about 2 to 14 days, the inflammation peaks, and then gradually subsides. 2/3 cases are After 1 month, the rest will last for several months. There are more white blood cells in the joint effusion, but the bacterial culture is negative, and can still be complicated with nodular erythema, iridocyclitis, choroiditis, arteritis, hemolytic Anemia and glomerulonephritis.
Examine
Examination of Yersinia enteritis in enterocolitis
1. Peripheral white blood cell count and neutrophils can be increased, erythrocyte sedimentation rate is often accelerated, and white blood cells and red blood cells can be seen in stool microscopy.
2. Leave specimens such as stool, blood, urine, sputum, cerebrospinal fluid, and mesenteric lymph nodes from the lesion to isolate Yersinia.
3. Serological examination: 1 The serum agglutination test in the recovery period is more than 4 times higher than the acute phase titer or the titer is more than 1:160. 2The serum anti-Yersinia outer membrane protein IgA, IgG detection is agglutination test More specific.
4. Other methods for detecting Yersin antigen in biopsy specimens by immunofluorescence, and detecting the combination of Yersinia enterocolitica and Yersinia pseudotuberculosis and PCR-probe in clinical and food samples by conventional PCR method , Nested-PCR method for detection of Yersinia enterocolitica.
Diagnosis
Diagnosis and diagnosis of Yersinia enteritis in enterocolitis
Anyone who eats suspiciously contaminated food or water; has a history of contact with infected animals; clinical fever, diarrhea, abdominal pain, sepsis, and inflammation or abscess in any part of the body, accompanied by symptoms of venom, should be suspected of Yersin The possibility of bacterial infection depends on bacteriological examination.
The disease should be differentiated from infectious diarrhea, sepsis, malaria, amebic liver abscess, acute appendicitis and jaundice hepatitis caused by other pathogens.
