Yersinia Yersinia Enterocolitica. Yersinia (a coliform & fecal coliform) is one of the Enterobacteriaceae. Infections include, aneurysms, endocarditis, severe abscess of the lung, diarrhea, hepatic and splenic, Focal (oral) infections, bacteremia, pharyngitis, meningitis, osteomyelitis, pyomyositis, conjunctivitis, pneumonia, acute proliferative glomerulonephritis, peritonitis, and primary cutaneous, necrotizlng "flesh eating" enterocolitis, pseudotuberculosis, acute gastroenteritis and mesenteric lymphadenitis, arthritis, septicemia, and erythema nodosum, Reiter's syndrome. It is antibiotic resistant and now produces poisonous Hydrogen Sulfide (H2S) gas. Yersinia is a thermotolerant bacteria that has become very deadly since 1976. According to the 1976 study, “Lung abscess and osteomyelitis of rib due to Yersinia enterocolitica,” by J. I. Sebes, et al., “Yersinia enterocolitica is a gram-negative organism that only recently has become known to infect man. Although the number of infections with Yersinia entercolitica has increased during the last few years, most reports came from Europe, Africa, Australia, and Japan. During the past year, Yersinia infections have been discovered in Canada and in the United States. – Most diseases caused by  Yersinia entercolitica are relatively benign; however, we have recently observed one case that presented as a severe abscess of the lung. This case is unique in that it is not only the first report of pulmonary disease with this organism, but also demonstrates the potential aggressiveness of this organism in areas outside the gastrointestinal tract. Our purpose is to report this unusual occurrence and to acquaint the physician with this organism and some of its manifestations.” http://chestjournal.chestpubs.org/content/69/4/546.full.pdf In the 1993 study, “Case report: Yersinia enterocolitica necrotizing pneumonia in an immunocompromised patient,” J.N. Greene, et al., said, “The authors report a rare case of Yersinia enterocolitica necrotizing pneumonia in an immunocompromised patient, who responded with resolution of the infection after 6 weeks of therapy with a third-generation cephalosporin but subsequently expired from the underlying lymphoma. In the few cases of Y. enterocolitica pulmonary infections that have been reported, the prognosis for cure of the infection is excellent with appropriate antibiotic therapy. Y. enterocolitica is likely to be recognized more frequently as a cause of serious infection in the growing immunosuppressed population. Early recognition and appropriate therapy can improve survival significantly.” http://www.ncbi.nlm.nih.gov/sites/entrez? cmd=Retrieve&db=PubMed&list_uids=8447337&dopt=Abstract According to the 2006 study, “Molecular Biogrouping of Pathogenic Yersinia enterocolitica - Development of a Diagnostic PCR Assay With Histologic Correlation,” Laura W. Lamps, MD, et al., reported, “Previous serologic, microbiologic, and molecular studies have implicated pathogenic strains of Y. enterocolitica as causative agents in numerous gastrointestinal inflammatory diseases, including appendicitis (granulomatous and suppurative), gastroenteritis, ileitis, colitis, and mesenteric lymphadenitis.[4,8,11,13-18] The spectrum of illness caused by Y. enterocolitica is extremely variable, ranging from acute self-limited gastroenteritis to fatal dissemination and sepsis. Food-borne outbreaks have been associated with virtually all pathogenic serovars. Serovar O:8 has characteristically been associated with more catastrophic human infection, whereas O:3 and O:9 have been linked to milder cases. – Six archival, formalin-fixed, paraffin-embedded patient specimens that had tested positive for pathogenic Y. enterocolitica chromosomal DNA using PCR analysis (see "Initial PCR Assay for the Y. enterocolitica ail Gene")[15,20,21] also were retrieved. Of the 6 cases, 3 were granulomatous appendicitis, 1 was malacoplakia of the appendix and right colon, 1 was a colon resection from a patient with acute Y. enterocolitica enterocolitis with perforation and sepsis, and 1 was a Y. enterocolitica soft tissue abscess.” http://www.medscape.com/viewarticle/530612_2 ` According to the 2009 American Academy of Pediatrics (AAP) Committee on Infectious Diseases Red Book Online, “Yersinia enterocolitica causes several age-specific syndromes and a variety of other less common presentations. Infection with Y. enterocolitica typically manifests as fever and diarrhea in young children; stool often contains leukocytes, blood, and mucus. Relapsing disease and, rarely, necrotizing enterocolitis also have been described. In older children and adults, a pseudoappendicitis syndrome (fever, abdominal pain, tenderness in the right lower quadrant of the abdomen, and leukocytosis) predominates. Bacteremia with Y. enterocolitica most often occurs in children younger than 1 year of age and in older children with predisposing conditions, such as excessive iron storage (e.g., desferrioxamine use, sickle cell disease, beta-thalassemia) and immunosuppressive states. Focal manifestations of Y. enterocolitica are uncommon and include pharyngitis, meningitis, osteomyelitis, pyomyositis, conjunctivitis, pneumonia, empyema, endocarditis, acute peritonitis, abscesses of the liver and spleen, and primary cutaneous infection. Post infectious sequelae with Y. enterocolitica infection include erythema nodosum, proliferative glomerulonephritis, and reactive arthritis; these sequelae occur most often in older children and adults, particularly people with HLA- B27 antigen.” http://aapredbook.aappublications.org/cgi/content/extract/2009/1/3.153 Yersinia enterocolitia in Animals “Yersinia enterocolitica, is often carried by many animal species, especially pigs, and associated with sporadic diarrhea in humans and animals. Farmed deer are highly susceptible.” Saunders Comprehensive Veterinary Dictionary, 3 ed. © 2007 Elsevier, Inc. All rights reserved Yersinia (Pasteurella) pestis, Black Death -- Yersinia pestis causes the bubonic, pneumonic, and septicemic plagues . Human contraction of bubonic plague is usually through flea bites. Once inside the body, Y. pestis releases a toxin which inhibits electron transport chain function. Swelling of the lymph nodes, skin blotches, and dilerium are sometimes observed within a few days of infection. Untreated infections usually result in death within a week of initial infection. http://www.boisestate.edu/courses/westciv/plague/02.shtml “Etymology: Alexandre E.J. Yersin; L, pestis, plague a species of small gram-negative bacteria that causes plague. The primary host is the rat, but other small rodents also harbor the organism. A person without symptoms may be a carrier, but this happens rarely. Yersinia pestis is hardy, living for long periods in infected carcasses, the soil of the host's habitat, or sputum. Also called Pasteurella pestis. See also plague.” Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier. In a 2007 study, “Multiple Antimicrobial Resistance in Plague: An Emerging Public Health Risk,” Timothy J. Welch, et al., United States Department of Agriculture (USDA), reported, “Antimicrobial resistance in Yersinia pestis is rare, yet constitutes a significant international public health and biodefense threat. In 1995, the first multidrug resistant (MDR) isolate of Y. pestis (strain IP275) was identified, and was shown to contain a self-transmissible plasmid (pIP1202) that conferred resistance to many of the antimicrobials recommended for plague treatment and prophylaxis. Comparative analysis of the DNA sequence of Y. pestis plasmid pIP1202 revealed a near identical IncA/C plasmid backbone that is shared by MDR plasmids isolated from Salmonella enterica serotype Newport SL254 and the fish pathogen Yersinia ruckeri YR71. The high degree of sequence identity and gene synteny between the plasmid backbones suggests recent acquisition of these plasmids from a common ancestor. In addition, the Y. pestis pIP1202-like plasmid backbone was detected in numerous MDR enterobacterial pathogens isolated from retail meat samples collected between 2002 and 2005 in the United States. Plasmid-positive strains were isolated from beef, chicken, turkey and pork, and were found in samples from the following states: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York and Oregon. Our studies reveal that this common plasmid backbone is broadly disseminated among MDR zoonotic pathogens associated with agriculture. This reservoir of mobile resistance determinants has the potential to disseminate to Y. pestis and other human and zoonotic bacterial pathogens and therefore represents a significant public health concern.” http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0000309 Plague is an endemic disease of rodents in the western United States, with occasional spread into human and non-rodent populations via enzootic or amplification hosts. Contributor’s comment about the plague in mule deer and blacktailed deer states: “The mule deer had bilateral ocular infection due to Yersinia pestis. In addition to these changes there were acute necrotizing inflammatory lesions in lung, adrenals, lymph node, and liver with intralesional bacteria, and disseminated intravascular coagulation. – Plague is unusual in big game animals and ungulates are generally considered resistant to the disease. There is a published report of plague in a free- ranging mule deer in Wyoming,1 an unpublished, laboratory-confirmed case in a mule deer in Montana, 2 and bilateral plague- associated necrotizing panophthalmitis in a blacktailed deer in California.3 Ocular plague has been seen in Colorado (Dr. M. Miller, Colorado Division of Wildlife, unpublished observations).” http://www.jwildlifedis.org/cgi/content/full/44/4/983 http://www.cwd.cc/Mule-deer_plagued_by_blindness.htm Yersinia was reported in an EPA sewage sludge compost study in 1988 Black Plague -- Yersinia pestis causes the bubonic, pneumonic, and septicemic plagues . Human contraction of bubonic plague is usually through flea bites. Once inside the body, Y. pestis releases a toxin which inhibits electron transport chain function. Swelling of the lymph nodes, skin blotches, and dilerium are sometimes observed within a few days of infection. Untreated infections usually result in death within a week of initial infection. Plague is an endemic disease of rodents in the western United States, with occasional spread into human and non-rodent populations via enzootic or amplification hosts. Yersinia enterocolitica (1976) is a gram-negative organism that only recently has become known to infect man. Although the number of infections with Yersiniia entercolitica has increased during the last few years, most  reports came from Europe, Africa, Australia, and Japan. During the past year, Yersinia infections have been discovered in Canada  and in the United States. Most diseases caused by Yersinia entercolitica are relatively benign; however, we have recently observed one case that presented as a severe abscess of the lung. This case is unique in that it is not only the first report of pulmonary disease with this organism, but also demonstrates the potential aggressiveness of this organism in areas outside the gastrointestinal tract. Our purpose is to report this unusual occurrence and to acquaint the physician with this organism and some of its manifestations. CLINICAL MANIFESTATIONS: Yersinia enterocolitica and Yersinia pseudotuberculosis cause several age-specific syndromes and a variety of uncommon presentations. The most common manifestation of infection with Y enterocolitica is enterocolitis with fever and diarrhea; stool often contains leukocytes, blood, and mucus. This syndrome occurs most often in young children. A pseudoappendicitis syndrome (fever, abdominal pain, tenderness in the right lower quadrant of the abdomen, and leukocytosis) occurs primarily in older children and young adults. Focal infections, abscess formation (such as hepatic and splenic), and bacteremia occur most often in patients with predisposing conditions, such as excessive iron storage. Other manifestations of infection are uncommon and include pharyngitis, meningitis, osteomyelitis, pyomyositis, conjunctivitis, pneumonia, acute proliferative glomerulonephritis, peritonitis, and primary cutaneous Of 187 newborns admitted to a 33-bed, level III neonatal intensive care unit between January 1, 1985 and June 23, 1985, 33 developed necrotlzlng enterocolitis during their hospital stay. Twenty of the 33 newborns (61%) had onset of symptoms between April 1 and June 23, suggesting clustering during this period. A case-control study, with matching on birth weIght class, approximate date of admission to the unit and approximate duration of stay, failed to reveal any association of the syndrome with type or timing of feeding, perinatal hypoxic events, as determined by apgar scores and labor history, or specific microbial organisms. By contrast, however, transfusion of packed red blood cells was highly and significantly associated with the syndrome (odds ratio = 15.1, 95% confidence interval = 2.59–92.51). In addition, therapy with caffeine, with theoph ylline, and with furosemide were moderately associated with the syndrome, although not significantly so. During this outbreak period, the Incidence of necrotizing enterocolitis by birth weight was 30.6% in infants less than 1,500 gm, 10.8% in infants 1,500–2,500 gm, and 11.9% in infants 2,500 gm or more. These findings confirm the importance of low birth weight as a risk factor for development of the syndrome and suggest that Insults to volume homeostasis, such as transfusion and use of diuretics, need to be considered as possible mechanisms whereby necrotizing enterocolitis is Initiated. The authors report (1993) a rare case of Yersinia enterocolitica necrotizing pneumonia in an immunocompromised patient, who responded with resolution of the infection after 6 weeks of therapy with a third-generation cephalosporin but subsequently expired from the underlying lymphoma. In the few cases of Y. enterocolitica pulmonary infections that have been reported, the prognosis for cure of the infection is excellent with appropriate antibiotic therapy. Y. enterocolitica is likely to be recognized more frequently as a cause of serious infection in the growing immunosuppressed population. Early recognition and appropriate therapy can improve survival significantly. The Cytotoxic Necrotizing Factors (2007)  from Yersinia pseudotuberculosis and from Escherichia coli Bind to Different Cellular Receptors but Take the Same Route to the Cytosol Eight pathogenic strains (O:1, O:2, O:4, O:13, O:15, O:20, O:21, and O:34) of Y enterocolitica were obtained from the Centers for Disease Control and Prevention (CDC), Atlanta, GA. These specimens were received as freeze-dried organisms, which subsequently were rehydrated with phosphate-buffered saline (PBS) before culture. Yer·sin·ia/ (yer-sin´e-ah) a genus of nonmotile, ovoid or rod-shaped, nonencapsulated, gram- negative bacteria (family Enterobacteriaceae); Y. enterocoli´tica is a ubiquitous species that causes acute gastroenteritis and mesenteric lymphadenitis in children and arthritis, septicemia, and erythema nodosum in adults; Y. pes´tis causes plague in humans and rodents, transmitted from rats to humans by the rat flea, and from person to person by the human body louse; Y. pseudotuberculo´sis causes disease in rodents and mesenteric lymphadenitis in humans. http://medical-dictionary.thefreedictionary.com/YERSINIA Yersinia genus: Y. enterocolitica and Y. pestis. Y. enterocolitica is the most often encountered species of Yersinia in the lab. This bacterium is an invasive pathogen which can penetrate the gut lining and enter the lymphatic system and the blood. Infection, which is usually through ingestion of contaminated foods, can cause a severe intestinal inflammation called yersiniosis. Release of its enterotoxin can cause severe pain similar to that found in patients with appendicitis. Yersinia enterocolitica (1984) Now that its role as a human pathogen is firmly established, reports documenting Yersinia enterocolitica infections are increasing worldwide. The organism has been encountered both sporadically and epidemically (3). Y. enterocolitica causes a diarrheal illness in children (10), and its association with Reiter's syndrome in adults is well known (6, 13), but only a handful of cases of primary soft tissue infection have been described. Contributor’s Comment: The mule deer had bilateral ocular infection due to Yersinia pestis. In addition to these changes there were acute necrotizing inflammatory lesions in lung, adrenals, lymph node, and liver with intralesional bacteria, and disseminated intravascular coagulation Plague is unusual in big game animals and ungulates are generally considered resistant to the disease. There is a published report of plague in a free-ranging mule deer in Wyoming,1 an unpublished, laboratory-confirmed case in a mule deer in Montana,2 and bilateral plague-associated necrotizing panophthalmitis in a blacktailed deer in California.3 Ocular plague has been seen in Colorado (Dr. M. Miller, Colorado Division of Wildlife, unpublished observations).