infectious diseases
Plague and Other Yersinia Infections
OtherYersiniaInfections
Yersinia enterocoliticaandY. pseudotuberculosisare zoonoses that occur worldwide and are acquired by ingestion or handling of contaminated food (most commonly raw or undercooked pork products and unpasteurized milk or milk products) or water and occasionally by animal contact. most commonly causes mesenteric adenitis and has been suspected in cases of Tubulointerstitial Nephritis , The organisms can be identified in standard cultures from normally sterile sites. Selective culture methods are required for nonsterile specimens, such as stool culture for diarrheal disease. It is important to notify the laboratory whenYersiniainfection is suspected in stool so that a special culture medium can be used. Serologic assays are available but difficult and not standardized. Diagnosis, particularly of reactive arthritis, requires a high index of suspicion and close communication with the clinical laboratory. Treatmentof diarrhea is supportive because the disease is self-limited. Septic complications require beta-lactamase–resistant antibiotics guided by susceptibility testing. Third-generation cephalosporins, fluoroquinolones, andtrimethoprim/sulfamethoxazole (TMP/SMX) are preferred. Preventionis focused on food handling and preparation, household pets, and epidemiology of suspected outbreaks. 