Clinical manifestations ofYersinia pseudotuberculosis infection in children

  • R. Tertti
  • R. Vuento
  • P. Mikkola
  • K. Granfors
  • A. -L. Mäkelä
  • A. Toivanen
Article

Abstract

The clinical manifestations of infection were analysed during an outbreak of 34 cases ofYersinia pseudotuberculosis serotype Ia infection. The diagnosis was based on the results of enzyme immunoassay and verified by stool culture in five cases. The first four patients were pupils from the same school, and information on any signs and symptoms of infection was obtained by questionnaire from pupils of the school. A blood sample was obtained from 101 children. Strong IgM and IgG antibody responses toYersinia pseudotuberculosis Ia were found in 13 (25%) of the 52 pupils who reported signs and symptoms of infection and in 9 (18%) of the 49 with no manifestations of infection. The vigorous immune response also resulted in effective opsonization of the causative microorganism. The most common symptoms were fever and abdominal pain. Three children operated on because of suspected appendicitis were found to have mesenteric lymphadenitis. Only one patient developed reactive arthritis. Analysis showed that a remarkable proportion ofYersinia pseudotuberculosis infections may be subclinical, and that individualYersinia pseudotuberculosis strains may have different capacities to cause postinfection complications.

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References

  1. 1.
    Ahvonen, P. Human yersiniosis in Finland. II. Clinical features. Annals of Clinical Research 1972, 4: 39–48.PubMedGoogle Scholar
  2. 2.
    Boyce, J. M. Yersinia species. In: Mandell, G. L., Douglas, G. R., Bennett, J. E. (ed.): Principles and practice of infectious diseases. Wiley Medical, New York, 1979, p. 1792–1800.Google Scholar
  3. 3.
    Leino, R., Renvall, S., Lipasti, J., Toivanen, A. Small-bowel gangrene caused byYersinia enterocolitica III. British Medical Journal 1980, 280: 1419.Google Scholar
  4. 4.
    Attwood, S. E. A., Mealy, K., Cafferkey, M. T., Buckley, T. F., West, A. B., Boyle, N., Healy, E., Keane, F. B. V. Yersinia infection and acute abdominal pain. Lancet 1987, i: 529–533.Google Scholar
  5. 5.
    Tertti, R., Granfors, K., Lehtonen, O.-P., Mertsola, J., Mäkelä, A.-L., Välimäki, I., Hänninen, P., Toivanen, A. An outbreak ofYersinia pseudotuberculosis infection. Journal of Infectious Diseases 1984, 149: 245–250.PubMedGoogle Scholar
  6. 6.
    Knapp, W. Mesenteric adenitis due toPasteurella pseudotuberculosis in young people. New England Journal of Medicine 1958, 259: 776–778.PubMedGoogle Scholar
  7. 7.
    Leino, R., Granfors, K., Havia, T., Heinonen, R., Lampinen, M., Toivanen, A. Yersiniosis as a gastrointestinal disease. Scandinavian Journal of Infectious Diseases 1987, 19: 63–68.PubMedGoogle Scholar
  8. 8.
    Aho, K., Ahvonen, P., Lassus, A., Sievers, K., Tiilikainen, A. HL-A antigen 27 and reactive arthritis. Lancet 1973, ii: 157.Google Scholar
  9. 9.
    Toivanen, A., Toivanen, P. Pathogenesis of reactive arthritis. In: Toivanen, A., Toivanen, P. (ed.) Reactive arthritis. CRC Press, Boca Raton, 1988, p. 167–177.Google Scholar
  10. 10.
    Knapp, W., Prögel, B., Knapp, C. Immunopathologische Komplikationen bei enteralen Yersiniosen. Deutsche medizinische Wochenschrift 1981, 106: 1054–1060.PubMedGoogle Scholar
  11. 11.
    Bottone, E. J. Current trends inYersinia enterocolitica isolates in the New York City area. Journal of Clinical Microbiology 1983, 17: 63–67.PubMedGoogle Scholar
  12. 12.
    Randall, K. J., Mair, N. S. Family outbreak ofPasteurella pseudotuberculosis infection. Lancet 1962, i: 1042–1043.Google Scholar
  13. 13.
    Black, R. E., Jackson, R. J., Tsai, T., Medvesky, M., Shayegani, M., Feeley, J. C., MacLeod, K. I. E., Wakelee, A. M. EpidemicYersinia enterocolitica infection due to contaminated chocolate milk. New England Journal of Medicine 1978, 298. 76–79.PubMedGoogle Scholar
  14. 14.
    Shayegani, M., Morse, D., DeForge, I., Root, T., Parsons, L. M., Maupin, P. S. Microbiology of major foodborne outbreak of gastroenteritis caused byYersinia enterocolitica serogroup O:8. Journal of Clinical Microbiology 1983, 17: 35–40.PubMedGoogle Scholar
  15. 15.
    Ratnam, A., Mercer, E., Picco, B., Parsons, S., Butler, R. A nosocomial outbreak of diarrheal disease due toYersinia enterocolitica serotype O:5, biotype 1. Journal of Infectious Diseases 1982, 145: 242–247.PubMedGoogle Scholar
  16. 16.
    Toivanen, P., Toivanen, A., Olkkonen, L., Aantaa, S. Hospital outbreak ofYersinia enterocolitica infection. Lancet 1973, i: 801–803.Google Scholar
  17. 17.
    Tauxe, R. V., Vandepitte, J., Wauters, G., Martin, S. M., Goossens, V., de Mol, P., van Noyen, R., Thiers, G. Yersinia enterocolitica infections and pork: the missing link. Lancet 1987, i: 1129–1132.Google Scholar
  18. 18.
    Doyle, M. P., Hugdahl, M. B., Taylor, S. L. Isolation of virulentYersinia enterocolitica from porcine tongues. Applied and Environmental Microbiology 1981, 42: 661–666.PubMedGoogle Scholar
  19. 19.
    Fukushima, H., Gomyoda, M., Shiozawa, K., Kaneko, S., Tsubokura, M. Yersinia pseudotuberculosis infection contracted through water contaminated by a wild animal. Journal of Clinical Microbiology 1988, 26: 584–585.PubMedGoogle Scholar
  20. 20.
    Laird, W. J., Cavanaugh, D. C. Correlation of auto-agglutination and virulence of yersiniae. Journal of Clinical Microbiology 1980, 11: 430–432.PubMedGoogle Scholar
  21. 21.
    Gemski, P., Lazere, J. R., Casey, T. Plasmid associated with pathogenicity and calcium dependency ofYersinia enterocolitica. Infection and Immunity 1980, 27: 682–685.PubMedGoogle Scholar
  22. 22.
    Granfors, K., Viljanen, M., Tiilikainen, A., Toivanen, A. Persistence of IgM, IgG, and IgA antibodies toYersinia in yersinia arthritis. Journal of Infectious Diseases 1980, 141: 424–429.PubMedGoogle Scholar
  23. 23.
    Tertti, R., Eerola, R., Lehtonen, O.-P., Ståhlberg, T. H., Viander, M., Toivanen, A. Virulence-plasmid is associated with the inhibition of opsonization inYersinia enterocolitica andYersinia pseudotuberculosis. Clinical and Experimental Immunology 1987, 68: 266–274.PubMedGoogle Scholar
  24. 24.
    Tertti, R., Eerola, E., Granfors, K., Lahesmaa-Rantala, R., Pekkola-Heino, K., Toivanen, A. Role of antibodies in the opsonization ofYersinia spp. Infection and Immunity 1988, 56: 1295–1300.PubMedGoogle Scholar
  25. 25.
    Winblad, S. Erythema nodosum associated with infection withYersinia enterocolitica. Scandinavian Journal of Infectious Diseases 1969, 1: 11–16.PubMedGoogle Scholar
  26. 26.
    Helander, I., Olkkonen, L., Hopsu-Havu, V. K. Yersinia infection as a cause of erythema nodosum. Zeitschrift für Haut und Geschlechts-Krankheiten 1973, 48: 399–404.Google Scholar
  27. 27.
    de Groote, G., Vandepitte, J., Wauters, G. Surveillance of humanYersinia enterocolitica infections in Belgium: 1963–1978. Journal of Infection 1982, 4. 189–197.PubMedGoogle Scholar
  28. 28.
    Jepsen, O. B., Korner, B., Lauritsen, K. B., Hancke, A.-B., Andersen, L., Henrichsen, S., Brenöe, E., Christiansen, P. M., Johansen, A. Yersinia enterocolitica infection in patients with acute surgical abdominal disease. Scandinavian Journal of Infectious Diseases 1976, 8: 189–194.PubMedGoogle Scholar
  29. 29.
    Leino, R., Mäkelä, A.-L., Tiilikainen, A., Toivanen, A. Yersinia arthritis in children. Scandinavian Journal of Rheumatology 1980, 9: 245–249.PubMedGoogle Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1989

Authors and Affiliations

  • R. Tertti
    • 1
  • R. Vuento
    • 1
  • P. Mikkola
    • 1
  • K. Granfors
    • 1
  • A. -L. Mäkelä
    • 2
  • A. Toivanen
    • 1
    • 3
  1. 1.Department of Medical MicrobiologyTurku UniversityTurku 52Finland
  2. 2.Department of PediatricsTurku UniversityTurku 52Finland
  3. 3.Department of MedicineTurku UniversityTurku 52Finland

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