總結

• In humans, Yersinia pestis causes plague, and Yersinia enterocolitica and Yersinia pseudotuberculosis cause yersiniosis.
• Plague affects many parts of the world, particularly Asia and Africa.
• The relative ease of culture and high fatality rates make Y pestis a potential biological weapon.
• Diagnosis of plague may be suggested by characteristic clinical findings (e.g., fever, lymphadenitis) together with a history of potential exposure in an endemic area. Yersiniosis presents generally as a self-limiting gastroenteritis, but invasive infection may occur. Microbiological studies are used to confirm a suspected diagnosis.
• Treatment of plague includes parenteral antibiotics. In a mass casualty setting (bioterrorist attack), oral therapy may be indicated. Early treatment is essential. A delay of >24 hours from the onset of systemic symptoms is associated with a high mortality.
• Post-exposure antibiotic prophylaxis is indicated in people who have been in close contact (within 2 m) with people with plague.
• Yersiniosis requires supportive care. Treatment with intravenous antibiotics is appropriate in patients with invasive infection.