title: Yersinia pseudotuberculosis infection intractable by antibiotics: A rare case report.
abstract: BACKGROUND
  Yersinia pseudotuberculosis infection is usually cured spontaneously or with administration of antibiotics.
  
  
  METHODS
  The patient is a twelve-year-old boy with right lower quadrant pain who had enterocolitis one month previously. Contrast-enhanced abdominal computed tomography showed a distended and edematous ileum and an intra-abdominal abscess adjacent to the mesentery with a normal appendix. The patient's general condition did not improve with antibiotics, so an ileocecectomy was performed.
  
  
  CONCLUSIONS
  Yersinia pseudotuberculosis infection requiring an operation is rare. In our case, antibiotics were not effective in treating the abscess therefore surgery was required. An early diagnosis using serological studies, ultrasound of the abdomen, and fecal culture, with appropriate administration of antibiotics, may have avoided the need for surgery. Considering YP infection as a differential diagnosis is therefore important when encountering patients with enterocolitis, especially with right lower quadrant pain. Early diagnosis may assist in avoiding unnecessary operations.
  
  
  CONCLUSIONS
  Diagnosis of YP infection may be missed or delayed because it is rare and difficult to detect, and must be distinguished from appendicitis. Although most YP infections are self-limiting, some rare cases will require surgery, therefore early diagnosis is essential.
authors.affiliation: Department of Pediatric Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555 Japan. Electronic address: me17022@s.okadai.jp.
authors.forename: Jiro
authors.initials: J
authors.lastname: Kimura
authors.affiliation: Department of Pediatric Surgery, Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555 Japan. Electronic address: 2kssk2@mail.bbexcite.jp.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sasaki
keywords: Ileocecectomy; Intra-abdominal abscess; Yersinia pseudotuberculosis