Yersinia enterocolitica and Pharyngitis
Yes, Yersinia enterocolitica can cause sore throat and pharyngitis, though this is an uncommon presentation that occurs primarily in adults rather than children.
Clinical Presentation of Yersinia Pharyngitis
Y. enterocolitica pharyngitis presents as sore throat and fever without enteritis, distinguishing it from the typical gastrointestinal manifestations 1. Key clinical features include:
- Sore throat as the primary symptom with fever, occurring without diarrhea or abdominal pain 1, 2
- Leukocytosis on laboratory testing 1
- Elevated convalescent-phase serum titers against Y. enterocolitica 1
- May require hospitalization in approximately 20% of cases (3 of 14 patients in one outbreak) 1
Age-Related Manifestations
Adults predominantly develop pharyngitis, while children typically present with enteritis 1, 3. This age-dependent pattern is critical for clinical recognition:
- All patients with pharyngitis in the documented outbreak were adults 1
- Children, particularly those under 1 year (85% of cases), primarily develop gastrointestinal symptoms 3
Broader Clinical Spectrum
Y. enterocolitica causes diverse manifestations beyond pharyngitis 4, 5:
- Nonbloody or bloody diarrhea as the most common presentation 4
- Febrile pseudoappendicular syndrome mimicking appendicitis 4
- Joint pain and erythematous rash in systemic cases 2
- Bacteremia particularly in infants under 3 months, immunocompromised patients, or those with iron overload states 4, 3
Diagnostic Considerations
Throat cultures positive for Y. enterocolitica confirm the diagnosis when other pathogens are excluded 1. Important diagnostic points:
- Consider Y. enterocolitica in sporadic pharyngitis cases with negative cultures for typical pathogens (Group A Streptococcus, viruses) 1
- Stool cultures may be negative in isolated pharyngitis 1
- Blood cultures should be obtained in severe cases or high-risk patients 3
Risk Factors and Epidemiology
Exposure to pork products, particularly chitterlings (raw pork intestines), is the primary risk factor 4, 3. Additional considerations:
- Higher incidence during winter months (November-January) 3
- Unpasteurized milk and contaminated water as transmission sources 5
- Young African American and Asian children at higher risk for gastrointestinal disease 4
Clinical Pitfall
Do not dismiss pharyngitis in adults with known pork exposure or during winter outbreaks, even without gastrointestinal symptoms 1. The absence of enteritis does not exclude Y. enterocolitica infection in the appropriate clinical context.