Aortoabdominal aneurysm infected by Yersinia enterocolitica serotype O:9.

A 78-year-old-man was hospitalized for surgical treatment of a Yersinia enterocolitica serotype O:9 infected primary aortoabdominal aneurysm which ruptured soon after admission. Infection of aneurysm is an unusual manifestation of yersiniosis, especially in patients with no predisposing underlying condition. This case, and review of the literature, highlights that serotype O:9 has a predilection for vascular tissue. Cross reaction with Brucella spp. may be responsible for misdiagnosis of Y. enterocolitica O:9 infected aneurysms.

Mycotic aneurysm due to Yersinia enterocolitica.

Infections of the cardiovascular system, besides involving both natural and prosthetic heart valves, vascular grafts, and indwelling venous and arterial cannulas, may cause mycotic aneurysms. The latter frequently complicate endocarditis; however, they may occur as isolated phenomena. Enterobacteriaceae are uncommon etiologic agents in vascular infections; however, a patient is reported who presented initially with a bacteremia due to Yersinia enterocolitica biogroup 4 and despite antimicrobial therapy developed a mycotic aneurysm of the left internal carotid artery. Clinical manifestations, pathogenesis, and treatment of yersiniosis are reviewed.

Splenic abscess as a complication of septic yersinia: CT evaluation.

Yersinia enterocolitica (YE) frequently causes gastrointestinal illness, but is rarely a cause of systemic infection. The complications of septic YE include a wide variety of extraintestinal manifestations, with a 34-50% mortality rate. We present a patient with septic YE complicated by a splenic abscess. The clinical presentation was nonspecific, and the diagnosis of splenic abscess was made by computed tomography (CT). Because of the nonspecific clinical presentation and the wide range of extraintestinal manifestations of septic YE, CT can prove helpful in the diagnosis and management of these patients.

[Appendicular pseudo-tumors: unusual diagnosis]. / Pseudo-tumeurs appendiculaires: diagnostics inhabituels.

The discovery of a tumour mass of the appendix, in an acute or chronic context, raises the problem of its benign or malignant, inflammatory or infectious nature. We report five cases of patients operated by the same surgical team between June 1991 and September 1996, who presented macroscopically and histologically with unusual appendicular pseudotumours: appendicular diverticulosis (n = 1), Crohn's disease localized to the appendix (n = 2), yersiniosis (n = 1), actinomycosis (n = 1). The preoperative diagnosis was acute appendicitis (n = 2) or tumour (n = 3). The postoperative course was uneventful in every case, and specific medical treatment was prescribed in two cases (yersiniosis and actinomycosis). These differential diagnoses must be considered in all appendicular diseases, but they are extremely difficult to confirm preoperatively.

Mesenteric lymph node abscess due to Yersinia enterocolitica: case report and review of the literature.

We describe the case of a 74-year-old female with a mesenteric lymph node abscess caused by a Yersinia enterocolitica infection. She had been administered an immunosuppressive drug and was admitted to the hospital due to a high fever, right lower abdominal pain and advanced leukocytosis. We initially diagnosed her with lymphadenitis based on the symptoms and the imaging studies. However, conservative treatment with antibiotics did not yield any improvement, and abscess formation was suspected. Surgical treatment was performed, and the culture from the drainage fluid grew Y. enterocolitica. The histological findings suggested that an ulcerative lesion of the terminal ileum was the entry port of Y. enterocolitica. The pathogen infected the mesenteric lymph nodes and spread along the ileocecal lymphatic vessels, resulting in the formation of an abscess. We also provide a review of the previously published literature on lymph node abscesses due to Y. enterocolitica infections.

Yersinia enterocolitica infection mimicking surgical conditions.

Yersinia enteritis may present with alarming gastrointestinal manifestations. The aim of this study was to review the cases of children admitted to a general hospital with a preliminary diagnosis of surgical nature and subsequently proven to be infected by Yersinia enterocolitica. All cases of children aged less than 14 years with stool cultures positive for Y. enterocolitica during the 12-year period January 1993 through December 2004 were analyzed. Y. enterocolitica was isolated from the stools of 71 children with gastrointestinal manifestations; 27 children were treated as outpatients and 44 were hospitalized. Six were admitted to the Pediatric Surgery Department (13.6% of the total hospitalizations and 8.4% of all Y. enterocolitica cases). Four of the Pediatric Surgery patients presented with abdominal pain and right lower quadrant tenderness. The preliminary diagnosis of appendicitis was excluded during hospitalization and none of them underwent appendectomy. The other two children were admitted for vomiting initially attributed to a preceding head injury and for diarrhea and a perianal abscess. Two children were given antibiotics and all had an excellent outcome. Y. enterocolitica enteritis manifestations can infrequently mimic appendicitis or other surgical conditions but should remain in the differential diagnosis of children presenting with an acute abdomen.

Acute yersiniosis and its surgical significance.

During early 1982, an outbreak of yersiniosis occurred in northern Mississippi. Abdominal pain suggestive of appendicitis was a common manifestation, but laparotomy revealed mesenteric adenitis. Yersinia enteritis should enter the differential diagnosis of acute appendicitis.

Yersiniosis as a surgical disease.

An infection with Yersinia strains may develop with the picture of acute appendicitis. Laparotomy will then not reveal an acutely inflamed appendix, but will often show mesenteric lymphadenitis or acute terminal ileitis. These conditions have been observed in four patients. The differential diagnostic possibilities are discussed. It is pointed out that acute terminal ileitis is practically never transformed into chronic terminal ileitis (Crohn's disease).

Hepatic abscess due to Yersinia enterocolitica without bacteremia.

A 71-yr-old diabetic patient was evaluated because of right upper quadrant pain. He was found to have a large hepatic abscess secondary to Yersinia enterocolitica infection. He lacked clinical evidence of bacteremia or gastrointestinal infection. It is postulated that Yersinia enterocolitica reached the liver through the portal system from an inapparent intestinal infection. This is the first reported case of a liver abscess secondary to Yersinia enterocolitica without evidence of systemic infection.

Yersinia enterocolitica colitis in infants: radiographic changes.

Radiographic changes of Yersinia enterocolitica colitis in 3 infants are presented. Findings included superficial aphthoid ulcers, submucosal ulcers, pancolitis (manifested by toxic megacolon), and involvement of the terminal ileum.