Yersinia infection - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Yersinia infection can cause plague or yersiniosis, both of which are notifiable conditions. Plague may be naturally occurring, or may potentially be the result of a bioterrorist attack.
Plague may be suggested by characteristic clinical findings together with a history of potential exposure in an endemic area. Microbiologic studies are used to confirm the diagnosis. Rapid antigen tests may be recommended in some settings.
Plague has a high case fatality rate if left untreated (particularly pneumonic plague), but is treatable with antibiotic therapy and supportive care. Patients with pneumonic plague should be isolated immediately and placed on standard and droplet precautions. Pre-exposure or postexposure prophylaxis may be required in people exposed to plague.
Yersiniosis generally presents as a self-limiting gastroenteritis. The mainstay of management is supportive care; however, antibiotics may be required in invasive infection.

Axillary bubo

From the image collection of the CDC; used with permission

Quick Reference

History & Exam
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

A female Xenopsylla cheopis flea, also known as the oriental rat flea
Axillary bubo
Bipolar appearance with Wright stain
Plague infection involving both lung fields
Gangrene of the right foot causing necrosis of the toes
Digital gangrene

Citations

Key Articles

World Health Organization. WHO guidelines for plague management. May 2021 [internet publication].[Full Text]
Nelson CA, Meaney-Delman D, Fleck-Derderian S, et al. Antimicrobial treatment and prophylaxis of plague: recommendations for naturally acquired infections and bioterrorism response. MMWR Recomm Rep. 2021 Jul 16;70(3):1-27.[Abstract][Full Text]

Other Online Resources

BMJ talk medicine podcast: plague - a guide to diagnosing and managing Yersinia with Dr Amesh Adalja
CDC: map of plague in the US
CDC: plague
CDC: Yersinia enterocolitica (yersiniosis)
WHO: plague

Referenced Articles

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42. US Food and Drug Administration. FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Jul 2018 [internet publication].[Full Text]
43. US Food and Drug Administration. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. December 2018 [internet publication].[Full Text]
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