Yersinia infection

Last reviewed: 22 Apr 2022
Last updated: 27 Oct 2021

Summary

Definition

History and exam

Key diagnostic factors

  • constitutional symptoms
  • lymphadenitis (bubonic plague)
  • haemoptysis (pneumonic plague)
  • diarrhoea (yersiniosis)
  • abdominal pain (yersiniosis)
More key diagnostic factors

Other diagnostic factors

  • pleuritic chest pain (pneumonic plague)
  • dyspnoea (pneumonic plague)
Other diagnostic factors

Risk factors

  • exposure to fleas (plague)
  • residence in, or travel to, an endemic area (plague)
  • contact with infected animals (plague)
  • bioterrorism (plague)
  • young children (yersiniosis)
  • consumption of raw or undercooked pork products (yersiniosis)
  • exposure to people with plague (plague)
  • iron-overload syndromes (yersiniosis)
  • chronic liver disease, diabetes, alcoholism (yersiniosis)
More risk factors

Diagnostic investigations

1st investigations to order

  • blood culture (plague)
  • bubo aspirate culture (bubonic plague)
  • sputum culture (pneumonic plague)
  • cerebrospinal fluid culture (septicaemic plague)
  • antigen detection (plague)
  • WBC count (plague)
  • chest x-ray (pneumonic plague)
  • stool culture (yersiniosis)
More 1st investigations to order

Investigations to consider

  • serology
More investigations to consider

Emerging tests

  • polymerase chain reaction (PCR)

Treatment algorithm

ACUTE

pneumonic or septicaemic plague: non-pregnant adults and children

bubonic or pharyngeal plague: non-pregnant adults and children

pneumonic, septicaemic, bubonic, or pharyngeal plague: pregnant

meningeal plague

yersiniosis

Contributors

Authors

John Williams, MRCP, DTM&H, Dip HIV Med
John Williams

Consultant Infectious Diseases Physician

Department of Infection and Travel Medicine

The James Cook University Hospital

Middlesbrough

UK

Disclosures

JW declares that he has no competing interests.

Peer reviewers

Vladimir L. Motin, PhD

Professor

Pathology/Microbiology and Immunology

University of Texas Medical Branch

Galveston

TX

Disclosures

VLM declares that he has no competing interests.

Waleed Javaid, MD, FACP, FIDSA

Associate Professor

Medical Director of Infection Control

Infectious Disease

Department of Medicine

SUNY Upstate Medical University

Syracuse

NY

Disclosures

WJ declares that he has no competing interests.

Alistair Leanord, BSc, MBChB, MD, DTM&H, FRCPath

Consultant Microbiologist

Microbiology Department

Southern General Hospital

Glasgow

UK

Disclosures

AL declares that he has no competing interests.

Janak Koirala, MD

Associate Professor of Medicine

Division of Infectious Diseases

Department of Internal Medicine

Southern Illinois University School of Medicine

Springfield

IL

Disclosures

JK declares that he has no competing interests.

  • Yersinia infection images
  • Differentials

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    • Bacterial pneumonia
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  • Guidelines

    • Plague: resources for clinicians
    • Antimicrobial treatment and prophylaxis of plague: recommendations for naturally acquired infections and bioterrorism response
    More Guidelines
  • Patient leaflets

    Appendicitis

    Diarrhoea in adults

    More Patient leaflets
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