SURGICAL ASPECTS OF AN OUTBREAK OF YERSINIA-ENTEROCOLITIS

Eleven patients with Yersinia enterocolitica infections were identifie d in the Upper Valley of New Hampshire and Vermont during October and November of 1995. Three children presented with an appendicitis like p icture. Two underwent appendectomy, one of whom was the outbreak's ind ex case. Both appendectomy patients presented with lower abdominal pai n, fever, vomiting, and a right lower quadrant mass associated with le ukocytosis. Both had terminal ileitis, and in both, cultures of perito neal fluid-and a mesenteric lymph node grew Y. enterocolitica. Even du ring 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 complicatio n of their disease.