title: Surgical aspects of an outbreak of Yersinia enterocolitis.
abstract: Eleven patients with Yersinia enterocolitica infections were identified in the Upper Valley of New Hampshire and Vermont during October and November of 1995. Three children presented with an appendicitis-like picture. Two underwent appendectomy, one of whom was the outbreak's index case. Both appendectomy patients presented with lower abdominal pain, fever, vomiting, and a right lower quadrant mass associated with leukocytosis. Both had terminal ileitis, and in both, cultures of peritoneal fluid and a mesenteric lymph node grew Y. enterocolitica. Even during an outbreak there is no consistently reliable nonoperative way to separate a sporadic case of appendicitis from one whose appendicitis-like symptoms are due to Yersinia. In addition, a small percentage of Yersinia patients will present with true appendicitis as a complication of their disease.
authors.affiliation: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Shorter
authors.forename: M D
authors.initials: MD
authors.lastname: Thompson
authors.forename: D P
authors.initials: DP
authors.lastname: Mooney
authors.forename: J F
authors.initials: JF
authors.lastname: Modlin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004760:Enterocolitis / Q000382:microbiology*; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007223:Infant; D009513:New Hampshire / Q000453:epidemiology; D014707:Vermont / Q000453:epidemiology; D015009:Yersinia Infections / Q000175:diagnosis / Q000453:epidemiology*