Shorter N A, Thompson M D, Mooney D P, Modlin J F
Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Pediatr Surg Int. 1998 Jan;13(1):2-5. doi: 10.1007/s003830050229.
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.
1995年10月至11月期间，在新罕布什尔州和佛蒙特州的上流域地区确认了11例小肠结肠炎耶尔森菌感染患者。3名儿童表现出类似阑尾炎的症状。其中2人接受了阑尾切除术，其中1人是此次疫情的首例病例。两名接受阑尾切除术的患者均出现下腹部疼痛、发热、呕吐，以及伴有白细胞增多的右下腹肿块。两人均患有末端回肠炎，两人的腹腔积液和肠系膜淋巴结培养物中均培养出小肠结肠炎耶尔森菌。即使在疫情期间，也没有一种始终可靠的非手术方法能够将散发性阑尾炎病例与阑尾炎样症状由耶尔森菌引起的病例区分开来。此外，一小部分耶尔森菌患者会出现真正的阑尾炎，作为其疾病的并发症。
