Diagnosis of yersiniosis

Yersiniosis is an acute intestinal infection that is accompanied by a toxic-allergic reaction. The disease is transmitted by the fecal-oral route. The reservoir of infectious agents can be rodents, livestock, dogs. People can also spread the infection, but the transmission of the disease from person to person is a rare occurrence.

The disease can be fatal. That is why it is so important to diagnose pathology in time. Treatment is appointed based on the results of the survey. Patients are placed in the infectious department. The main goal of the therapeutic process is to fight the pathogen. The causative agents of yersiniosis are well preserved in water and in soil. They survive freezing with subsequent thawing.

Pathogenic microflora is sensitive to drying, boiling, as well as exposure to sunlight and chemical disinfectants. The implementation of infection routes is facilitated by insufficiently thermally processed products of animal origin, as well as contaminated water sources. The main factors in the transmission of the pathogen are vegetable dishes and dairy products.

The use of water from open reservoirs is another way of transmitting an infectious agent. In this article, we will talk in detail about the basis on which the diagnosis of "Yersiniosis" is made. Let's consider, with what pathologies differential diagnostics should be spent, and also we learn, on what the expert pays attention at survey of the patient.

What is necessary to make a diagnosis?

If the first signs of an illness appear, the patient should consult a gastroenterologist and infectious disease specialist. In case of complications, it may be necessary to consult a nephrologist, neurologist and cardiologist.

For the detection of intestinal yersiniosis, infectious disease specialist

will be required Diagnosis of yersiniosis involves conducting such studies:

• bacteriological culture of a nasopharyngeal smear and sputum;
• blood test;
• ECG;
• analysis of urine, feces, cerebrospinal fluid, bile;
• ultrasound of the abdominal cavity;
• colonoscopy;
• CT;
• immunological and serological tests;
• laparoscopy;
• radiography;
• sonography;
• sigmoidoscopy.

Biological material for conducting microbiological diagnostics is:

• cal;
• urine;
• blood;
• sputum;
• washes from the mouth;
• is a bile secret;
• cerebrospinal fluid;
• tissue taken during surgery.

Bacteriological seeding of the room in which the patient is located is also carried out. It is also worth researching vegetables, fruits, dishes, kitchen utensils. Bacteriological analysis has a number of disadvantages. First of all, this is due to the low concentration of infectious agents in the biomaterial, especially in the blood. To obtain the most accurate result, the use of at least four samples is required.

It is also worth noting that this diagnostic technique requires a lot of time. So one analysis can take from two weeks to a month, and this makes it difficult to conduct the treatment process. For these reasons, specialists often disregard bakposive or designate it in conjunction with other studies. A more reliable analysis for the diagnosis is the detection of antibodies in the patient's blood.

In the case of gastrointestinal yersiniosis in ninety percent of cases, the presence of an infectious agent can be accurately detected or excluded. Serological analysis can be done from the second week after the onset of the disease. For the reliability of the diagnosis, two weeks later, a second study is conducted. In exceptional cases, antibodies to Yersinia are found within a few years after recovery.

To confirm the diagnosis, the blood is taken for the detection of antibodies

Clinical study

These include the collection of an anamnesis of the patient and an external examination. Anamnestic data includes the following information: the course of the disease, the clinical symptoms, the time of the onset of the first signs, the circumstances that, in the patient's opinion, could cause the ailment. When palpation, there is a pain in the abdomen.

The patient can inform the doctor of a sudden onset of the disease. The disease is characterized by an increase in body temperature, weakness, weakness, aches in joints and muscles, headache. You can learn more about the features of iersiniosis in children from this article. At the initial stages, the infectious disease is almost always manifested by symptoms of gastrointestinal lesions:

• nausea;
• vomiting;
• abdominal pain;
• diarrhea.

In generalized form, the patient's condition is severe. The skin becomes icteric, peripheral lymph nodes, liver are enlarged, and hemorrhagic rash appears. The secondary focal form manifests itself in the form of lesions of the parenchymal organs. Patients can be diagnosed with such diseases:

• myocarditis;
• meningitis;
• arthritis;
• hepatitis;
• Reiter syndrome;
• erythema nodosum;
• is an inflammation of the lungs.

Patients can complain of joint pain, swelling and a restriction in their mobility. A characteristic symptom of secondary focal yersiniosis is a small-spotty rash on the feet and hands. There is also a pain in the heart and a violation of the heart rate.

On examination, a physician can pay attention to the following characteristic signs of yersiniosis: skin rash, raspberry tongue, paleness or icterus of the skin, abundant lacrimation, redness of the conjunctiva of the eyes. When palpation, the patient has a painful outbreak in the epigastrium, navel or right iliac region. Also, the spleen, liver and lymph nodes can be enlarged.

On examination, the physician draws attention to the rash in the region of the hands and feet.

. Differential analysis of

. To establish an accurate diagnosis, a comparative analysis of iersiniosis with other pathologies, namely dysentery, salmonella, food-borne diseases. In all of these diseases, there are some symptoms that are characteristic of iersiniosis:

• cough and runny nose;
• skin rash;
• enlargement of the liver and lymph nodes;
• joint pain;
• of jaundice;
• pain and burning when urinating, urinary incontinence.

If at a yersiniosis a fever can be kept during two weeks, at salmonellosis and a dysentery she usually lasts no more than two days. Also, with these pathologies, the pain does not have a cramping character. For iesrniasis, pain is characteristic in the ileal and right iliac region.

Dysentery is characterized by the appearance of unpleasant sensations in the lower abdomen, and in case of salmonellosis and toxic infections - in the upper or middle part of the abdominal cavity. With yersiniosis, there is a loose stool, sometimes with impurities of mucus and blood. Dysentery is characterized by a lean chair, in which there may also be a mucus secret and blood.

In case of toxic infections and salmonellosis, the feces acquire a greenish tinge and offensive odor. The abdominal form of an infectious disease is easily confused with acute appendicitis. For differentiation, the doctor draws attention to the fact that in the inflammation of the appendix, there is no enlargement of the liver, jaundice, and pain in the right upper quadrant.

If acute appendicitis begins with pain in the right ileal region, and then the symptoms of intoxication develop, then the abdominal form of yersiniosis is characterized by the appearance of fever, weakness, headache, against which the abdominal pain develops. Differences are also visible in the duration of pain. With yersiniosis they have a periodic cramping character. And with acute appendicitis, the pain worries constantly.

Differential diagnosis of yersiniosis and pseudotuberculosis presents difficulties. This is particularly the case when the generalized and secondary focal form is compared with the same forms of pseudotuberculosis. This is associated with a diverse clinical picture. The decisive moment in the diagnosis is the results of the research.

Techniques

Laboratory diagnostics includes a large number of studies, which we will talk about.

The blood test for yersiniosis is the most informative method for the study of

ELISA

This method is based on a specific antigen-antibody reaction. Venous blood must be taken for it. The biological material is collected on an empty stomach. Indications for a blood test are the following:

• pain and bloating;
• diarrhea with impurities of blood and mucus;
• skin rash;
• increase in body temperature to 39-40 0C;
• fever;
• aches in muscles and joints.

The analysis is conducted for the purpose of differential diagnosis of acute intestinal infections. A positive result indicates the presence of the current acute intestinal yersiniosis or an early transferred disease. Doubtful results may result from a recently transferred infection or an early stage of the pathological process. In this case, the study should be repeated in one to two weeks.

General and biochemical blood analysis

Biological material is placed in special vacuums after the fence. In the general analysis, laboratory workers pay attention to the parameters of blood cells, hemoglobin, hematocrit, and erythrocyte sedimentation rate. With yersiniosis, anemia can occur. Also, the parameters of ESR and white blood cells increase. In a biochemical study, the concentration of enzymes, proteins, minerals and metabolic products in the blood is determined.

In the general blood test, anemia is detected, as well as the shift of the leukocyte formula

. Genetic analysis of

. Blood, feces, and vomit can be taken as a biological material. The essence of the method is based on the identification of a DNA pathogen of an infectious disease. One of the advantages of PCR diagnostics is high accuracy. This is explained by the following reasons:

• correct sampling and transportation of biomaterial;
• use of sterile and disposable instruments;
• compliance with sterility;
• strict adherence to the rules and stages of the methodology.

Microbiological study of

With this technique, it is possible to isolate the causative agent of the infection in pure form. For the analysis, blood, feces, rinses from the pharynx, vomit and others are taken. Biological material is placed in special media in which favorable conditions for the active development of the infectious agent are created.

So, early diagnosis of iersiniosis is the key to successful treatment. The examination of the patient begins with the collection of anamnesis and examination of the patient. Push a doctor at the thought of the presence of the disease can skin rash, digestive disorders, intoxication, jaundice.

An accurate diagnosis is made based on the results of laboratory tests. Identify the causative agent of the disease can be by bacteriological inoculation. The technique has a number of disadvantages, so it is prescribed in conjunction with other analyzes. High accuracy is the serological and immunological methods of investigation.

Yersiniosis can cause serious complications and cause death. To avoid this, even when the first symptoms appear, consult a specialist. Do not let the disease run its course, especially for young children. A careful attitude to your body can even save your life. Your health is in your hands!