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Yersinia enterocolitica infection in pediatric patients

Maria Luís Sacras1; Inês Serras1; Margarida Pinto2; Maria João Brito1

1 - Pediatric Infectious Diseases Unit, Hospital Dona Estefânia – CHLC - EPE, Lisbon, Portugal
2 - Clinical Pathology Service, Hospital Dona Estefânia – CHLC - EPE, Lisbon, Portugal

- 7th Europediatrics, Florença, 13-16 de Maio de 2015 (Poster)

Introduction Yersinia enterocolitica is a gram-negative bacillus. These bacteria cause disease by invasion and tissue destruction..
Objectives: Characterize Yersinia enterocolitica infection in a pediatric population.
Methods: Descriptive study in child admitted in a terciary hospital from January 1st 2012 to 31th December 2014. The bacteria were isolated by fecal culture. Age, gender, season, clinical, laboratory and treatment data was collected.
Results: From a total of 12 cases, 9/12 (75%) were female, 8/12 (67%) were less than 2 years old and 8/12 (67%) presented in fall and winter. Clinical manifestations were characterized by diarrhea (12/12, 100%), with 10-15 bowel movements/ day (6/12 patients, 50%), with mucous and/or blood (7/12, 58%), abdominal pain (5/12, 42%) and vomits (2/12, 17%). Eight of the twelve patients (67%) had complications: dehydration (7/12, 58%), weight loss (5/12, 42%) and intussusception (1 case, 8%). This same patient is now under evaluation because of a celiac disease suspicion. Three in twelve patients (25%) had leucocytosis (leucocytes > 15000/L) and in 8/12 (67%) C-reactive protein was > 50 mg/L. The diagnosis were gastroenteritis (8 cases, 67%), ileo-colitis (3 cases, 25%) and mesenteric adenitis (1 case, 8%). The majority of cases (10/12, 83%) were treated with antibiotic and trimetropim-sulfametoxazol was the most prescribed.
Conclusions: The most common clinical manifestations were the expected but there was a high rate of complications (8/12, 67%). Although intussusception in children is usually idiopathic and bacteria are a rare cause, Yersinia is the most common bacterial agent isolated. The value of antibiotic therapy has not been established but the complications rate justified its use in this study.

Palavras Chave: yersinia infection; fecal culture; complications.