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.