Two cases of abdominal pain in children with mesenteric lymphadenitis due to Yersinia pseudotuberculosis infection

A 5,000-year-old hunter-gatherer already plagued by Yersinia pestis

A 5,000-year-old Yersinia pestis genome (RV 2039) is reconstructed from a hunter-fisher-gatherer (5300-5050 cal BP) buried at Riņņukalns, Latvia. RV 2039 is the first in a series of ancient strains that evolved shortly after the split of Y. pestis from its antecessor Y. pseudotuberculosis ∼7,000 years ago. The genomic and phylogenetic characteristics of RV 2039 are consistent with the hypothesis that this very early Y. pestis form was most likely less transmissible and maybe even less virulent than later strains. Our data do not support the scenario of a prehistoric pneumonic plague pandemic, as suggested previously for the Neolithic decline. The geographical and temporal distribution of the few prehistoric Y. pestis cases reported so far is more in agreement with single zoonotic events.

Yersinia pseudotuberculosis infection intractable by antibiotics: A rare case report

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Yersinia pseudotuberculosis infection is usually cured only by administering antibiotics.

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The operation must have been performed for this patient because of persistent Yersinia pseudotuberculosis infection.

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Early diagnosis and administering antibiotics are important for Yersinia pseudotuberculosis infection to avoid unnecessary operations.

Introduction

Yersinia pseudotuberculosis infection is usually cured spontaneously or with administration of antibiotics.

Presentation of case

The patient is a twelve-year-old boy with right lower quadrant pain who had enterocolitis one month previously. Contrast-enhanced abdominal computed tomography showed a distended and edematous ileum and an intra-abdominal abscess adjacent to the mesentery with a normal appendix. The patient’s general condition did not improve with antibiotics, so an ileocecectomy was performed.

Discussion

Yersinia pseudotuberculosis infection requiring an operation is rare. In our case, antibiotics were not effective in treating the abscess therefore surgery was required. An early diagnosis using serological studies, ultrasound of the abdomen, and fecal culture, with appropriate administration of antibiotics, may have avoided the need for surgery. Considering YP infection as a differential diagnosis is therefore important when encountering patients with enterocolitis, especially with right lower quadrant pain. Early diagnosis may assist in avoiding unnecessary operations.

Conclusion

Diagnosis of YP infection may be missed or delayed because it is rare and difficult to detect, and must be distinguished from appendicitis. Although most YP infections are self-limiting, some rare cases will require surgery, therefore early diagnosis is essential.