YERSINIA ENTEROCOLITICA: DIFFERENTIAL DIAGNOSIS WITH APPENDICITIS, MESENTERIC ADENITIS AND INFLAMMATORY BOWEL DISEASE

Key words: Yersinia enterocolitica, Enteritis, Pseudo-appendicular syndrome, IIeitis

We report a case of a 11-year old boy with Yersinia enterocolitica (YE) enteritis mimicking initially acute appendicitis. The following clinical course was characterized by persistent periciecal adenitis associated with elevated levels of inflammatory indices, leading to consider the diagnosis of chronic inflammatory bowel disease. The diagnosis of YE infection was made by positive stool culture. The patient’s clinical situation spontaneously improved and antibiotic treatment was not necessary. YE infection is thought to be relatively infrequent in general population. The clinical spectrum of YE may range from a self limited enteritis, mesenteric adenitis, pseudoappendicitis, ileocolitis, to extraintestinal manifestations and post-infectious reactions, such as nodosum erythema. This case-report suggests to consider the diagnosis of YE infection in case of persistent mesenteric adenitis or terminal ileitis.