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A 50-year-old man presented with a two-day history of pericardial type pain. The pain was in his left chest and exacerbated by inspiration and lying flat. During the preceding three weeks he had diarrhoea and abdominal pain. Physical examination was normal and he was afebrile. He reported a three-week history of persistent diarrhoea that did not affect any other household members.

Investigations revealed an initial Troponin I (TnI) of 17,566ng/L (reference range 0–34 ng/L), C-reactive protein (CRP) 160mg/L (normal <5mg/L) and a D-dimer of 689ug/L (reference range <500ug/L), but a normal blood count. The ECG showed 2mm ST elevation in leads V2–V6, I and II and no reciprocal changes (Figure 1). An echocardiogram showed normal structure and function of the heart with no pericardial effusion. A computed tomography coronary angiogram showed no obstructive coronary disease.

Figure 1: ECG taken from the patient on the first day of his presentation to hospital. There is 2mm ST elevation in leads V2–V6, I and II and no reciprocal changes.

Stool culture identified Yersinia enterocolitica, a notifiable disease in New Zealand, and excluded Clostridium difficile, norovirus, astrocvirus, rotavirus, adenovirus 40/41 and sapovirus. We diagnosed myopericarditis associated with Y. enterocolitica.

Progress

The patient remained stable and afebrile during his admission. Monitoring with telemetry showed normal sinus rhythm. His cardiac markers and CRP decreased over his admission while he was not on any antimicrobials due to awaiting stool culture. Following culture results, his infection was managed with a 10-day course of oral ciprofloxacin. Upon follow-up 10 days post initial presentation, the CRP and TnI had resolved (5mg/mL and 10ng/L respectively). He completed the course of antibiotics and had no further gastrointestinal symptoms. A follow-up echocardiogram showed normal ventricular size and systolic function.

Discussion

The genus Yersinia is a group of gram-negative coccobacilli bacteria from the family Enterobacteriaceae. The Yersinia genus are facultative anaerobes, several species of which are motile below 37oC.

The first known member of the Yersinia genus, Y. pestis, was independently identified in 1894 by both Alexadre Yersin and Kiasato Shibasabuō, Swiss and Japanese bacteriologists respectively.[[1]] Y. pestis achieved infamy as the cause of the “Black Death” that swept through Eurasia and North Africa. Since then, several species of the Yersinia genus have been identified, including Y. enterocolitica, first identified in 1934 by McIver and Pike[[2]] but not comprehensively described until 1968 by Sonnenwirth[[3]].

Y. enterocolitica is a gram-negative, frigophilic, asporgeneous rod, able to grow at 4oC and survive freezing. Yersinosis is an animal-borne disease that can affect humans, most commonly through undercooked pork and contaminated milk or water. Yersinosis typically causes a self-limiting enterocolitis, terminal illieitis or adenitis in humans, which can be managed in the community but may present resembling appendicitis. Common symptoms are dependent on age. Children under 5 experience fever, abdominal pain and bloody diarrhoea, and older children and adults experience abdominal pain as the principal symptom.[[4]] Typically, infection management would involve only hydration and nutritional support if necessary. However, in some instances, it may be advisable to treat the infection directly. Previous studies have shown that Y. enterocolitica is often resistant to penicillins (such as ampicillin and ticarcillin) and the first-generation cephalosporin cefazolin, but it is typically sensitive to the third and fourth generation cephalosporins (cefotaxime, ceftriaxone and cefepime) as well as some fluoroquinolones (ciprofloxacin), aminoglycosides (gentamicin and tobramycin) and sulfonamides (sulphamethoxazole/trimethoprim).[[5]]

In New Zealand, Yersinosis is a relatively common diagnosis of bacterial gastroenteritis, with 1,202 cases reported in 2018, a rate of 24.6/100,000. Only one death from Yersinosis was reported in New Zealand between 1999 and 2018.[[6]]

The most common route of transmission for Y. enterocolitica infection is via food, especially pork, but it has also been associated with untreated water, animal contact and human-to-human transmission.[[7]] Interestingly, this patient had minimal risk factors for Y. enterocolitica infection. He did not report eating any unusual foods, rarely consumed pork and did not consume raw or undercooked meats. He did not drink unpasteurised milk or live or work rurally. He had no contact with livestock and no sick household contacts. The water supply at his home and work were provided by the local councils and were from secure groundwater that is UV treated or chlorinated water. However, it is worth nothing that most Y. enterocolitica infections in New Zealand are sporadic and have no identifiable source.[[7]]

It is unusual for Y. enterocolitica to be associated with myopericarditis. A literature review showed only one published case in the English literature,[[8]] one case in German[[9]] and three in Danish.[[10–12]] Several larger case series have alluded to potential cases of Y. enterocolitica myocarditis, although without the necessary clinical detail for comparison to our case.[[13–15]]

The mechanism by which Yersinia infection results in myopericarditis is uncertain. It has been postulated that this reaction could be an immune sequalae due to molecular mimicry.[[4]] However, there has been evidence of direct Yersinia infection of the myocardium in animals, one puppy and one foetal foal.[[16–17]] As we could not exclude direct infection of the myocardium, we elected to treat with a course of antibiotics and the patient recovered without sequalae.

Summary

Abstract

Aim

We report a case of myopericarditis associated with Yersinia enterocolitica infection in an otherwise well 50-year-old man. We discuss the clinical features, microbiology and treatment of this rare cause of myopericarditis.

Method

Results

Conclusion

Author Information

Hayley Nehoff: 6th year medical student, University of Otago, Christchurch. Edward Henley: House officer, Department of Cardiology, Christchurch. Rebecca Hamblin: Registrar, Department of infectious diseases, Christchurch. Heather Isenman: Consultant, Department of infectious diseases, Christchurch. Ian Crozier: Consultant, Department of Cardiology, Christchurch.

Acknowledgements

Correspondence

Dr Ian Crozier, Consultant, Department of Cardiology, Christchurch, 04 3364 0640

Correspondence Email

Ian.crozier@cdhb.health.nz

Competing Interests

No funding was attained for the publication of this paper. Ian Crozier is a Consultant for Medtronic. Also receives research grants and fellowship support from Medtronic.

1) Zietz BP, Dunkelberg H. The history of the plague and the research on the causative agent Yersinia pestis. Int J Hyg Environ Health. 2004;207(2):165-78.

2) McIver MA, Pike RM. Chronic glanders-like infection of face caused by an organism resembling Flavobacterium pseudomallei: Whitmore. Clinical miscellany Vol 1, Mary imogene Basset Hospital Cooperstown NY (1934), pp. 16-21.

3) Sonnenwirth AC. Bacteremia with and without meningitis due to Yersinia enterocolitica Edwardsiella tarda Commomonas terrigena and Pseudomonas maltophila. Ann NY Acad Sci. 1970;174:1488-502.

4) Bottone EJ. Yersinia enterocolitica: overview and epidemiologic correlates. Microbes Infect. 1999;1:323-33.

5) Abdel-Haq NM, Papadopol R, Asmar BI, et al. Antibiotic susceptibilities of Yersinia enterocolitica recovered from children over a 12-year period. Int J Antimicrobial Agents. 2006; 27(5): 449-52.

6) The Institute of Environmental Science and Research Ltd. Notifiable Diseases in New Zealand: Annual Report 2018. Porirua, New Zealand. ISSN: 1179-3058. https://surv.esr.cri.nz/PDF_surveillance/AnnualRpt/AnnualSurv/2018/2018AnnualNDReport_FINAL.pdf

7) Rivas L, Strydom H, Paine S et al. Yersiniosis in New Zealand. Pathogens. 2021 10;10(2):191.

8) Pazdernik M, Kautzner J, Koudelkova E et al. Perimyocarditis Due to Yersinia enterocolitica in an Adult. Infect Dis Clin Practice. 2011;19(3):232-3.

9) Zöllner B, Sobottka I, von der Lippe G, et al. Perimyokarditis durch Yersinia enterocolitica Serotyp 0:3 Dtsch Med Wochenschr. 1992;117(47):1794-7.

10) Agner E, Larsen JH, Leth A. Pericarditis and elevated antibody titre for Yersinia enterocolitica. Ugeskr Laeger. 1978;140(25):1479-1481.

11) Agner E, Larsen JH, Leth A. Yersinia enterocolitica carditis as a differential diagnosis-and the prognosis of this disease. Scand J Rheumatol. 1978;7(1):26-28.

12) Mosekilde L, Strunge P. Yersinia enterocolitica arthritis and myocarditits. Ugeskr Laeger. 1978;140(25):1482-1483.

13) Marsal L, Winblad S, Wollheim FA. Yersinia enterocolitica arthritis in southern Sweden: a four-year follow-up study. Br Med J (Clin Res Ed). 1981;283(6284):101-3.

14) Winblad S. Arthritis associated with Yersinia enterocolitica infections. Scand J Infect Dis. 1975;7(3):191-5.

15) Saebø A, Lassen J. A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. Scand J Infect Dis. 1991;23(5):517-27.

16) Wibbelt G, Kelly, DF. Sudden death in a Rottweiler puppy with myocardial Yersinosis. Eur J Vet Path. 2001;7(3):135-7.

17) Costa LS, Cristo TG, Conti C et al. Sepsis due to Yersinia enterocolitica in an aborted equine fetus: case report. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 2021;3(2):417-22.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

A 50-year-old man presented with a two-day history of pericardial type pain. The pain was in his left chest and exacerbated by inspiration and lying flat. During the preceding three weeks he had diarrhoea and abdominal pain. Physical examination was normal and he was afebrile. He reported a three-week history of persistent diarrhoea that did not affect any other household members.

Investigations revealed an initial Troponin I (TnI) of 17,566ng/L (reference range 0–34 ng/L), C-reactive protein (CRP) 160mg/L (normal <5mg/L) and a D-dimer of 689ug/L (reference range <500ug/L), but a normal blood count. The ECG showed 2mm ST elevation in leads V2–V6, I and II and no reciprocal changes (Figure 1). An echocardiogram showed normal structure and function of the heart with no pericardial effusion. A computed tomography coronary angiogram showed no obstructive coronary disease.

Figure 1: ECG taken from the patient on the first day of his presentation to hospital. There is 2mm ST elevation in leads V2–V6, I and II and no reciprocal changes.

Stool culture identified Yersinia enterocolitica, a notifiable disease in New Zealand, and excluded Clostridium difficile, norovirus, astrocvirus, rotavirus, adenovirus 40/41 and sapovirus. We diagnosed myopericarditis associated with Y. enterocolitica.

Progress

The patient remained stable and afebrile during his admission. Monitoring with telemetry showed normal sinus rhythm. His cardiac markers and CRP decreased over his admission while he was not on any antimicrobials due to awaiting stool culture. Following culture results, his infection was managed with a 10-day course of oral ciprofloxacin. Upon follow-up 10 days post initial presentation, the CRP and TnI had resolved (5mg/mL and 10ng/L respectively). He completed the course of antibiotics and had no further gastrointestinal symptoms. A follow-up echocardiogram showed normal ventricular size and systolic function.

Discussion

The genus Yersinia is a group of gram-negative coccobacilli bacteria from the family Enterobacteriaceae. The Yersinia genus are facultative anaerobes, several species of which are motile below 37oC.

The first known member of the Yersinia genus, Y. pestis, was independently identified in 1894 by both Alexadre Yersin and Kiasato Shibasabuō, Swiss and Japanese bacteriologists respectively.[[1]] Y. pestis achieved infamy as the cause of the “Black Death” that swept through Eurasia and North Africa. Since then, several species of the Yersinia genus have been identified, including Y. enterocolitica, first identified in 1934 by McIver and Pike[[2]] but not comprehensively described until 1968 by Sonnenwirth[[3]].

Y. enterocolitica is a gram-negative, frigophilic, asporgeneous rod, able to grow at 4oC and survive freezing. Yersinosis is an animal-borne disease that can affect humans, most commonly through undercooked pork and contaminated milk or water. Yersinosis typically causes a self-limiting enterocolitis, terminal illieitis or adenitis in humans, which can be managed in the community but may present resembling appendicitis. Common symptoms are dependent on age. Children under 5 experience fever, abdominal pain and bloody diarrhoea, and older children and adults experience abdominal pain as the principal symptom.[[4]] Typically, infection management would involve only hydration and nutritional support if necessary. However, in some instances, it may be advisable to treat the infection directly. Previous studies have shown that Y. enterocolitica is often resistant to penicillins (such as ampicillin and ticarcillin) and the first-generation cephalosporin cefazolin, but it is typically sensitive to the third and fourth generation cephalosporins (cefotaxime, ceftriaxone and cefepime) as well as some fluoroquinolones (ciprofloxacin), aminoglycosides (gentamicin and tobramycin) and sulfonamides (sulphamethoxazole/trimethoprim).[[5]]

In New Zealand, Yersinosis is a relatively common diagnosis of bacterial gastroenteritis, with 1,202 cases reported in 2018, a rate of 24.6/100,000. Only one death from Yersinosis was reported in New Zealand between 1999 and 2018.[[6]]

The most common route of transmission for Y. enterocolitica infection is via food, especially pork, but it has also been associated with untreated water, animal contact and human-to-human transmission.[[7]] Interestingly, this patient had minimal risk factors for Y. enterocolitica infection. He did not report eating any unusual foods, rarely consumed pork and did not consume raw or undercooked meats. He did not drink unpasteurised milk or live or work rurally. He had no contact with livestock and no sick household contacts. The water supply at his home and work were provided by the local councils and were from secure groundwater that is UV treated or chlorinated water. However, it is worth nothing that most Y. enterocolitica infections in New Zealand are sporadic and have no identifiable source.[[7]]

It is unusual for Y. enterocolitica to be associated with myopericarditis. A literature review showed only one published case in the English literature,[[8]] one case in German[[9]] and three in Danish.[[10–12]] Several larger case series have alluded to potential cases of Y. enterocolitica myocarditis, although without the necessary clinical detail for comparison to our case.[[13–15]]

The mechanism by which Yersinia infection results in myopericarditis is uncertain. It has been postulated that this reaction could be an immune sequalae due to molecular mimicry.[[4]] However, there has been evidence of direct Yersinia infection of the myocardium in animals, one puppy and one foetal foal.[[16–17]] As we could not exclude direct infection of the myocardium, we elected to treat with a course of antibiotics and the patient recovered without sequalae.

Summary

Abstract

Aim

We report a case of myopericarditis associated with Yersinia enterocolitica infection in an otherwise well 50-year-old man. We discuss the clinical features, microbiology and treatment of this rare cause of myopericarditis.

Method

Results

Conclusion

Author Information

Hayley Nehoff: 6th year medical student, University of Otago, Christchurch. Edward Henley: House officer, Department of Cardiology, Christchurch. Rebecca Hamblin: Registrar, Department of infectious diseases, Christchurch. Heather Isenman: Consultant, Department of infectious diseases, Christchurch. Ian Crozier: Consultant, Department of Cardiology, Christchurch.

Acknowledgements

Correspondence

Dr Ian Crozier, Consultant, Department of Cardiology, Christchurch, 04 3364 0640

Correspondence Email

Ian.crozier@cdhb.health.nz

Competing Interests

No funding was attained for the publication of this paper. Ian Crozier is a Consultant for Medtronic. Also receives research grants and fellowship support from Medtronic.

1) Zietz BP, Dunkelberg H. The history of the plague and the research on the causative agent Yersinia pestis. Int J Hyg Environ Health. 2004;207(2):165-78.

2) McIver MA, Pike RM. Chronic glanders-like infection of face caused by an organism resembling Flavobacterium pseudomallei: Whitmore. Clinical miscellany Vol 1, Mary imogene Basset Hospital Cooperstown NY (1934), pp. 16-21.

3) Sonnenwirth AC. Bacteremia with and without meningitis due to Yersinia enterocolitica Edwardsiella tarda Commomonas terrigena and Pseudomonas maltophila. Ann NY Acad Sci. 1970;174:1488-502.

4) Bottone EJ. Yersinia enterocolitica: overview and epidemiologic correlates. Microbes Infect. 1999;1:323-33.

5) Abdel-Haq NM, Papadopol R, Asmar BI, et al. Antibiotic susceptibilities of Yersinia enterocolitica recovered from children over a 12-year period. Int J Antimicrobial Agents. 2006; 27(5): 449-52.

6) The Institute of Environmental Science and Research Ltd. Notifiable Diseases in New Zealand: Annual Report 2018. Porirua, New Zealand. ISSN: 1179-3058. https://surv.esr.cri.nz/PDF_surveillance/AnnualRpt/AnnualSurv/2018/2018AnnualNDReport_FINAL.pdf

7) Rivas L, Strydom H, Paine S et al. Yersiniosis in New Zealand. Pathogens. 2021 10;10(2):191.

8) Pazdernik M, Kautzner J, Koudelkova E et al. Perimyocarditis Due to Yersinia enterocolitica in an Adult. Infect Dis Clin Practice. 2011;19(3):232-3.

9) Zöllner B, Sobottka I, von der Lippe G, et al. Perimyokarditis durch Yersinia enterocolitica Serotyp 0:3 Dtsch Med Wochenschr. 1992;117(47):1794-7.

10) Agner E, Larsen JH, Leth A. Pericarditis and elevated antibody titre for Yersinia enterocolitica. Ugeskr Laeger. 1978;140(25):1479-1481.

11) Agner E, Larsen JH, Leth A. Yersinia enterocolitica carditis as a differential diagnosis-and the prognosis of this disease. Scand J Rheumatol. 1978;7(1):26-28.

12) Mosekilde L, Strunge P. Yersinia enterocolitica arthritis and myocarditits. Ugeskr Laeger. 1978;140(25):1482-1483.

13) Marsal L, Winblad S, Wollheim FA. Yersinia enterocolitica arthritis in southern Sweden: a four-year follow-up study. Br Med J (Clin Res Ed). 1981;283(6284):101-3.

14) Winblad S. Arthritis associated with Yersinia enterocolitica infections. Scand J Infect Dis. 1975;7(3):191-5.

15) Saebø A, Lassen J. A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. Scand J Infect Dis. 1991;23(5):517-27.

16) Wibbelt G, Kelly, DF. Sudden death in a Rottweiler puppy with myocardial Yersinosis. Eur J Vet Path. 2001;7(3):135-7.

17) Costa LS, Cristo TG, Conti C et al. Sepsis due to Yersinia enterocolitica in an aborted equine fetus: case report. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 2021;3(2):417-22.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

A 50-year-old man presented with a two-day history of pericardial type pain. The pain was in his left chest and exacerbated by inspiration and lying flat. During the preceding three weeks he had diarrhoea and abdominal pain. Physical examination was normal and he was afebrile. He reported a three-week history of persistent diarrhoea that did not affect any other household members.

Investigations revealed an initial Troponin I (TnI) of 17,566ng/L (reference range 0–34 ng/L), C-reactive protein (CRP) 160mg/L (normal <5mg/L) and a D-dimer of 689ug/L (reference range <500ug/L), but a normal blood count. The ECG showed 2mm ST elevation in leads V2–V6, I and II and no reciprocal changes (Figure 1). An echocardiogram showed normal structure and function of the heart with no pericardial effusion. A computed tomography coronary angiogram showed no obstructive coronary disease.

Figure 1: ECG taken from the patient on the first day of his presentation to hospital. There is 2mm ST elevation in leads V2–V6, I and II and no reciprocal changes.

Stool culture identified Yersinia enterocolitica, a notifiable disease in New Zealand, and excluded Clostridium difficile, norovirus, astrocvirus, rotavirus, adenovirus 40/41 and sapovirus. We diagnosed myopericarditis associated with Y. enterocolitica.

Progress

The patient remained stable and afebrile during his admission. Monitoring with telemetry showed normal sinus rhythm. His cardiac markers and CRP decreased over his admission while he was not on any antimicrobials due to awaiting stool culture. Following culture results, his infection was managed with a 10-day course of oral ciprofloxacin. Upon follow-up 10 days post initial presentation, the CRP and TnI had resolved (5mg/mL and 10ng/L respectively). He completed the course of antibiotics and had no further gastrointestinal symptoms. A follow-up echocardiogram showed normal ventricular size and systolic function.

Discussion

The genus Yersinia is a group of gram-negative coccobacilli bacteria from the family Enterobacteriaceae. The Yersinia genus are facultative anaerobes, several species of which are motile below 37oC.

The first known member of the Yersinia genus, Y. pestis, was independently identified in 1894 by both Alexadre Yersin and Kiasato Shibasabuō, Swiss and Japanese bacteriologists respectively.[[1]] Y. pestis achieved infamy as the cause of the “Black Death” that swept through Eurasia and North Africa. Since then, several species of the Yersinia genus have been identified, including Y. enterocolitica, first identified in 1934 by McIver and Pike[[2]] but not comprehensively described until 1968 by Sonnenwirth[[3]].

Y. enterocolitica is a gram-negative, frigophilic, asporgeneous rod, able to grow at 4oC and survive freezing. Yersinosis is an animal-borne disease that can affect humans, most commonly through undercooked pork and contaminated milk or water. Yersinosis typically causes a self-limiting enterocolitis, terminal illieitis or adenitis in humans, which can be managed in the community but may present resembling appendicitis. Common symptoms are dependent on age. Children under 5 experience fever, abdominal pain and bloody diarrhoea, and older children and adults experience abdominal pain as the principal symptom.[[4]] Typically, infection management would involve only hydration and nutritional support if necessary. However, in some instances, it may be advisable to treat the infection directly. Previous studies have shown that Y. enterocolitica is often resistant to penicillins (such as ampicillin and ticarcillin) and the first-generation cephalosporin cefazolin, but it is typically sensitive to the third and fourth generation cephalosporins (cefotaxime, ceftriaxone and cefepime) as well as some fluoroquinolones (ciprofloxacin), aminoglycosides (gentamicin and tobramycin) and sulfonamides (sulphamethoxazole/trimethoprim).[[5]]

In New Zealand, Yersinosis is a relatively common diagnosis of bacterial gastroenteritis, with 1,202 cases reported in 2018, a rate of 24.6/100,000. Only one death from Yersinosis was reported in New Zealand between 1999 and 2018.[[6]]

The most common route of transmission for Y. enterocolitica infection is via food, especially pork, but it has also been associated with untreated water, animal contact and human-to-human transmission.[[7]] Interestingly, this patient had minimal risk factors for Y. enterocolitica infection. He did not report eating any unusual foods, rarely consumed pork and did not consume raw or undercooked meats. He did not drink unpasteurised milk or live or work rurally. He had no contact with livestock and no sick household contacts. The water supply at his home and work were provided by the local councils and were from secure groundwater that is UV treated or chlorinated water. However, it is worth nothing that most Y. enterocolitica infections in New Zealand are sporadic and have no identifiable source.[[7]]

It is unusual for Y. enterocolitica to be associated with myopericarditis. A literature review showed only one published case in the English literature,[[8]] one case in German[[9]] and three in Danish.[[10–12]] Several larger case series have alluded to potential cases of Y. enterocolitica myocarditis, although without the necessary clinical detail for comparison to our case.[[13–15]]

The mechanism by which Yersinia infection results in myopericarditis is uncertain. It has been postulated that this reaction could be an immune sequalae due to molecular mimicry.[[4]] However, there has been evidence of direct Yersinia infection of the myocardium in animals, one puppy and one foetal foal.[[16–17]] As we could not exclude direct infection of the myocardium, we elected to treat with a course of antibiotics and the patient recovered without sequalae.

Summary

Abstract

Aim

We report a case of myopericarditis associated with Yersinia enterocolitica infection in an otherwise well 50-year-old man. We discuss the clinical features, microbiology and treatment of this rare cause of myopericarditis.

Method

Results

Conclusion

Author Information

Hayley Nehoff: 6th year medical student, University of Otago, Christchurch. Edward Henley: House officer, Department of Cardiology, Christchurch. Rebecca Hamblin: Registrar, Department of infectious diseases, Christchurch. Heather Isenman: Consultant, Department of infectious diseases, Christchurch. Ian Crozier: Consultant, Department of Cardiology, Christchurch.

Acknowledgements

Correspondence

Dr Ian Crozier, Consultant, Department of Cardiology, Christchurch, 04 3364 0640

Correspondence Email

Ian.crozier@cdhb.health.nz

Competing Interests

No funding was attained for the publication of this paper. Ian Crozier is a Consultant for Medtronic. Also receives research grants and fellowship support from Medtronic.

1) Zietz BP, Dunkelberg H. The history of the plague and the research on the causative agent Yersinia pestis. Int J Hyg Environ Health. 2004;207(2):165-78.

2) McIver MA, Pike RM. Chronic glanders-like infection of face caused by an organism resembling Flavobacterium pseudomallei: Whitmore. Clinical miscellany Vol 1, Mary imogene Basset Hospital Cooperstown NY (1934), pp. 16-21.

3) Sonnenwirth AC. Bacteremia with and without meningitis due to Yersinia enterocolitica Edwardsiella tarda Commomonas terrigena and Pseudomonas maltophila. Ann NY Acad Sci. 1970;174:1488-502.

4) Bottone EJ. Yersinia enterocolitica: overview and epidemiologic correlates. Microbes Infect. 1999;1:323-33.

5) Abdel-Haq NM, Papadopol R, Asmar BI, et al. Antibiotic susceptibilities of Yersinia enterocolitica recovered from children over a 12-year period. Int J Antimicrobial Agents. 2006; 27(5): 449-52.

6) The Institute of Environmental Science and Research Ltd. Notifiable Diseases in New Zealand: Annual Report 2018. Porirua, New Zealand. ISSN: 1179-3058. https://surv.esr.cri.nz/PDF_surveillance/AnnualRpt/AnnualSurv/2018/2018AnnualNDReport_FINAL.pdf

7) Rivas L, Strydom H, Paine S et al. Yersiniosis in New Zealand. Pathogens. 2021 10;10(2):191.

8) Pazdernik M, Kautzner J, Koudelkova E et al. Perimyocarditis Due to Yersinia enterocolitica in an Adult. Infect Dis Clin Practice. 2011;19(3):232-3.

9) Zöllner B, Sobottka I, von der Lippe G, et al. Perimyokarditis durch Yersinia enterocolitica Serotyp 0:3 Dtsch Med Wochenschr. 1992;117(47):1794-7.

10) Agner E, Larsen JH, Leth A. Pericarditis and elevated antibody titre for Yersinia enterocolitica. Ugeskr Laeger. 1978;140(25):1479-1481.

11) Agner E, Larsen JH, Leth A. Yersinia enterocolitica carditis as a differential diagnosis-and the prognosis of this disease. Scand J Rheumatol. 1978;7(1):26-28.

12) Mosekilde L, Strunge P. Yersinia enterocolitica arthritis and myocarditits. Ugeskr Laeger. 1978;140(25):1482-1483.

13) Marsal L, Winblad S, Wollheim FA. Yersinia enterocolitica arthritis in southern Sweden: a four-year follow-up study. Br Med J (Clin Res Ed). 1981;283(6284):101-3.

14) Winblad S. Arthritis associated with Yersinia enterocolitica infections. Scand J Infect Dis. 1975;7(3):191-5.

15) Saebø A, Lassen J. A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. Scand J Infect Dis. 1991;23(5):517-27.

16) Wibbelt G, Kelly, DF. Sudden death in a Rottweiler puppy with myocardial Yersinosis. Eur J Vet Path. 2001;7(3):135-7.

17) Costa LS, Cristo TG, Conti C et al. Sepsis due to Yersinia enterocolitica in an aborted equine fetus: case report. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 2021;3(2):417-22.

Contact diana@nzma.org.nz
for the PDF of this article

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