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Yersinia Enterocolitica

Practice Essentials

Yersinia enterocolitica (see the image below) is a bacterial species in the family Enterobacteriaceae that most often causes enterocolitis, acute diarrhea, terminal ileitis, mesenteric lymphadenitis, and pseudoappendicitis but, if it spreads systemically, can also result in fatal sepsis.

Gram stain of Yersinia enterocolitica.

Gram stain of Yersinia enterocolitica.

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Signs and symptoms

Symptoms of Y enterocolitica infection typically include the following:

Diarrhea – The most common clinical manifestation of this infection; diarrhea may be bloody in severe cases

Low-grade fever

Abdominal pain – May localize to the right lower quadrant

Vomiting – Present in approximately 15-40% of cases

The patient may also develop erythema nodosum, which manifests as painful, raised red or purple lesions, mainly on the patient’s legs and trunk. Lesions appear 2-20 days after the onset of fever and abdominal pain and resolve spontaneously in most cases in about a month.

See Clinical Presentation for more detail.


The following tests can be used in the diagnosis of Y enterocolitica infection:

Stool culture – This is the best way to confirm a diagnosis of Y enterocolitica
; the culture result is usually positive within 2 weeks of onset of disease

Tube agglutination

Enzyme-linked immunosorbent assays


Imaging studies – Ultrasonography or computed tomography (CT) scanning may be useful in delineating true appendicitis from pseudoappendicitis

Colonoscopy – Findings may vary and are relatively nonspecific

Joint aspiration in cases of Yersinia- associated reactive arthropathy

See Workup for more detail.


Care in patients with Y enterocolitica infection is primarily supportive, with good nutrition and hydration being mainstays of treatment.

First-line drugs used against the bacterium include the following agents:

Third-generation cephalosporins

Trimethoprim-sulfamethoxazole (TMP-SMZ)


Fluoroquinolones – not approved for use in children under 18 years


See Treatment and Medication for more detail.

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