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Mesenteric lymphadenitis caused by Yersinia enterocolitica.

Zińczuk J, Wojskowicz P, Kiśluk J, Fil D, Kemona A, Dadan J - Prz Gastroenterol (2015)

Bottom Line: It can be transmitted by the consumption of originally contaminated food products (pork, unpasteurized milk) or secondarily contaminated with animal or vegetable products.Infection caused by Y. enterocolitica can occur in different clinical forms: food poisoning, colitis, mesentric lymphadenitis, erythema nodosum, arthritis, pharyngitis, pneumonia, meningitis, sepsis.The aim of this study was to present a rare case of infection with Y. enterocolitica mesenteric lymph nodes coexistent with appendicitis.

View Article: PubMed Central - PubMed

Affiliation: Department of General Pathomorphology, Medical University of Bialystok, Bialystok, Poland.

ABSTRACT
Yersiniosis is an acute or chronic, zoonotic disease caused by infection of Gram-negative rods Yersinia enterocolitica. It can be transmitted by the consumption of originally contaminated food products (pork, unpasteurized milk) or secondarily contaminated with animal or vegetable products. The clinical picture of infection may have a variable course is related to the age and physical condition of the patient, or pathogenic properties of microorganisms. Infection caused by Y. enterocolitica can occur in different clinical forms: food poisoning, colitis, mesentric lymphadenitis, erythema nodosum, arthritis, pharyngitis, pneumonia, meningitis, sepsis. The aim of this study was to present a rare case of infection with Y. enterocolitica mesenteric lymph nodes coexistent with appendicitis.

No MeSH data available.


Related in: MedlinePlus

Lymph node with clearly visible lymph follicles. Magnification 4×, H + E staining
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Figure 0003: Lymph node with clearly visible lymph follicles. Magnification 4×, H + E staining

Mentions: The patient was qualified for surgical treatment ad hoc. During the operation a large amount of amber-coloured liquid was observed in the abdominal cavity as well as appendicitis, numerous enlarged (1–2 cm) mesenteric lymph nodes, and Meckel's diverticulum with broad base without inflammation, located approximately 50 cm from the ileocecal valve. Appendectomy was performed along with biopsy of mesenteric lymph node. Postoperative complications were not observed. After 3 days the patient was dismissed home in good general state and with recommendation of further antibiotic therapy (ciprofloxacin 2 × 500 mg p.o.) and control visit in the Surgical Outpatient Clinic 7 days after the surgery. During the control visit the patient felt well, the wound was healed, and the stitches were removed. Once again, ultrasonography was performed and revealed a hint of fluid between the intestinal loops and a large amount of hypoechogenic lymph nodes of 39 × 18 mm. As a result, continuation of antibiotic therapy was recommended. Histopathological examination of removed appendicitis revealed phlegmonous appendicitis, and, in mesenteric lymph nodes, significant hyperplasia of lymphoid follicles with enlargement of proliferation centres with visible infiltration from multilayer neutrophilic granulocytes was observed (Figures 3–5). What is more, in histopathological image microabscesses were observed (Figure 6), which suggested adenitis mesenterica caused by Y. enterocolitica. Final recognition of yersiniosis was confirmed by serological test performed with ELISA. This examination of serum was conducted in order to find antibodies for Yersinia outer proteins and purified O antigens (lipopolysaccharide) obtained from microbes from different serological groups of Y. enterocolitica. The assay of antibody titre for Yersinia outer proteins in different classes of immunoglobins gave the following results: IgA – 49 (negative < 15), IgG – 1235 (negative < 75), and IgM – 204 (negative < 15). The above results confirmed our previous hypothesis.


Mesenteric lymphadenitis caused by Yersinia enterocolitica.

Zińczuk J, Wojskowicz P, Kiśluk J, Fil D, Kemona A, Dadan J - Prz Gastroenterol (2015)

Lymph node with clearly visible lymph follicles. Magnification 4×, H + E staining
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4631276&req=5

Figure 0003: Lymph node with clearly visible lymph follicles. Magnification 4×, H + E staining
Mentions: The patient was qualified for surgical treatment ad hoc. During the operation a large amount of amber-coloured liquid was observed in the abdominal cavity as well as appendicitis, numerous enlarged (1–2 cm) mesenteric lymph nodes, and Meckel's diverticulum with broad base without inflammation, located approximately 50 cm from the ileocecal valve. Appendectomy was performed along with biopsy of mesenteric lymph node. Postoperative complications were not observed. After 3 days the patient was dismissed home in good general state and with recommendation of further antibiotic therapy (ciprofloxacin 2 × 500 mg p.o.) and control visit in the Surgical Outpatient Clinic 7 days after the surgery. During the control visit the patient felt well, the wound was healed, and the stitches were removed. Once again, ultrasonography was performed and revealed a hint of fluid between the intestinal loops and a large amount of hypoechogenic lymph nodes of 39 × 18 mm. As a result, continuation of antibiotic therapy was recommended. Histopathological examination of removed appendicitis revealed phlegmonous appendicitis, and, in mesenteric lymph nodes, significant hyperplasia of lymphoid follicles with enlargement of proliferation centres with visible infiltration from multilayer neutrophilic granulocytes was observed (Figures 3–5). What is more, in histopathological image microabscesses were observed (Figure 6), which suggested adenitis mesenterica caused by Y. enterocolitica. Final recognition of yersiniosis was confirmed by serological test performed with ELISA. This examination of serum was conducted in order to find antibodies for Yersinia outer proteins and purified O antigens (lipopolysaccharide) obtained from microbes from different serological groups of Y. enterocolitica. The assay of antibody titre for Yersinia outer proteins in different classes of immunoglobins gave the following results: IgA – 49 (negative < 15), IgG – 1235 (negative < 75), and IgM – 204 (negative < 15). The above results confirmed our previous hypothesis.

Bottom Line: It can be transmitted by the consumption of originally contaminated food products (pork, unpasteurized milk) or secondarily contaminated with animal or vegetable products.Infection caused by Y. enterocolitica can occur in different clinical forms: food poisoning, colitis, mesentric lymphadenitis, erythema nodosum, arthritis, pharyngitis, pneumonia, meningitis, sepsis.The aim of this study was to present a rare case of infection with Y. enterocolitica mesenteric lymph nodes coexistent with appendicitis.

View Article: PubMed Central - PubMed

Affiliation: Department of General Pathomorphology, Medical University of Bialystok, Bialystok, Poland.

ABSTRACT
Yersiniosis is an acute or chronic, zoonotic disease caused by infection of Gram-negative rods Yersinia enterocolitica. It can be transmitted by the consumption of originally contaminated food products (pork, unpasteurized milk) or secondarily contaminated with animal or vegetable products. The clinical picture of infection may have a variable course is related to the age and physical condition of the patient, or pathogenic properties of microorganisms. Infection caused by Y. enterocolitica can occur in different clinical forms: food poisoning, colitis, mesentric lymphadenitis, erythema nodosum, arthritis, pharyngitis, pneumonia, meningitis, sepsis. The aim of this study was to present a rare case of infection with Y. enterocolitica mesenteric lymph nodes coexistent with appendicitis.

No MeSH data available.


Related in: MedlinePlus