Extraintestinal Manifestation of Yersinia pseudotuberculosis Bacteremia as Acute Hepatitis: Case Report and Review of the Literature.

Yersinia pseudotuberculosis is a causative agent of foodborne zoonosis that usually causes self-limiting pseudoappendicitis. Y. pseudotuberculosis infection also causes systemic spread or extraintestinal manifestations in patients with predisposing conditions. Here, we present a case of acute hepatitis with Y. pseudotuberculosis bacteremia in a 30-year-old man. He was previously healthy without significant medical history other than obesity and current smoking. At the time of admission, he presented with high fever accompanied by chills, jaundice, abdominal pain, and watery diarrhea. Laboratory studies revealed leukocytosis and elevated liver function parameters. A stool culture showed no causative pathogens. Empiric antibiotic therapy with ceftriaxone and metronidazole was administered. Y. pseudotuberculosis was later isolated from the initial blood culture performed on the day of admission using MALDI-TOF mass spectrometry. Antibiotic treatment was continued based on the susceptibility testing results from MALDI-TOF MS and VITEk®2, as well as clinical and laboratory improvements. The patient was discharged on the tenth day of admission and remained healthy with no recurrence during the 12-month follow-up. Here, we review the literature on the systemic infection caused by Y. pseudotuberculosis, including extraintestinal manifestations. This case highlights that Y. pseudotuberculosis may be considered a differential causative organism in patients with acute colitis and hepatitis.

Disease-specific impairment of the quality of life in adult patients with chronic spontaneous urticaria.

BACKGROUND/AIMS: Chronic urticaria (CU) is a common skin disorder characterized by wheals and pruritus lasting more than 6 weeks. Due to its long duration and changeable symptoms, the quality of life (QOL) of patients with CU can be impaired substantially. We evaluated the CU-QOL, a previously validated CU-specific QOL measure, and investigated factors influencing QOL in chronic spontaneous urticaria (CSU) patients. METHODS: A hospital-based cross-sectional study was performed on 390 adult patients diagnosed with CSU from March 2009 to December 2012 at the Allergy and Clinical Immunology Clinic at Ajou University Hospital. The CU-QOL questionnaire, urticaria activity score (UAS), combined angioedema, and serum total immunoglobulin E (IgE) levels were investigated. RESULTS: The average CU-QOL score obtained from the questionnaire was 70.6 (of 100 points). The CU-QOL scores correlated significantly with the UAS, particularly with the 15-point UAS (UAS-15; coefficient -0.532, p < 0.01) rather than the 6-point UAS (-0.502, p < 0.01). The patients presenting with angioedema and urticaria had poorer scores in the urticaria symptom domain than those with urticaria alone (37.4 vs. 46.9, p = 0.004). Log-transformed serum total IgE levels correlated significantly with CU-QOL (-0.131, p < 0.05). Multivariate regression models indicated that severe CU (UAS-15 score ≥ 13), log (total IgE), and the presence of angioedema were significant predictors of impaired CU-QOL (< 85 points). CONCLUSIONS: CU has a substantial negative impact on QOL. The assessment of UAS-15, total IgE, and the presence of angioedema can be useful to predict QOL of the patients with CSU.

Effects of micro-perforated film on the quality and shelf life improvements of pork loins during chilled storage.

The effects of micro-perforated film (MPF) packaging method on the quality and shelf life of pork loin during chilled storage were investigated, compared with non-packaging (control) and non-perforated film (PPF) packaging. Loins were removed from five hogs after slaughter and chilling, and each loin was portioned into four parts. These samples (40 sections) were allocated to each of five intervals (0, 1, 4, 7 and 14 days) to minimize variation among treatments and stored for 14 days under 55±10% relative humidity and 0±1 °C. Total aerobic counts of control sample were significantly lower than those from MPF or PPF loins after 14 days of storage. At 14 days, the counts of Pseudomonas and Enterobacteriaceae in the samples from MPF were significantly lower than those from PPF. At 7 days, 'L' value for the control and 'a' value for PPF were significantly lower, and ΔE values for the control were significantly higher than other samples. During storage time, percentage weight loss was the most in the control samples with MPF following and PPF the least. Accordingly, water contents decreased highest in the control samples followed by those from MPF and PPF. TBA values increased with storage time, however no significant differences were observed among treatments. Sensory evaluation analyses showed that MPF samples were generally better evaluated in all parameters over the storage time. Therefore, it has been concluded that MPF could be used as an effective packaging technology since it extends the shelf life of fresh meat by controlling the microbial growth and evaporation at a moderate level.