We report one case of acute mesenteric lymphadenitis due to Yersinia pseudotuberculosis 5b in a 11-year old girl, had triphasic fever and scarlatinform rash and localized pain on right on right lower abdomen, mimicking acute appendicitis and
scarlet
fever initially, She had histories of intermittent drinking of untreated water and close contact with two pet cats. At operation, appendix in retrocecal position was normal except three palpable fecaliths, but there were multiple enlarged
mesenteric
lymph nodes, showing variable size and darkish yellow colors. Y. pseudotuberculosis was isolated from the mesenteric lymph nodes but not from stool, appendix, blood or drinking water, Agglutinating serum antibody against the serotype 5b strain of
Y.
pseudotuberculosis was detected with titers of 1:160 in her serum.
The isolate was facultative anaerobic Gram-negative coccobacillus that was colorless on (Mac Conkey and salmonella-shigella media, pink on) Cefsulodin-lrgasan-Novobiochin (CIN)media, K/A on TSI, and motile at 22℃but not at 37℃. In biochemical
reaction, oxidase, indole, VP and citrate were negative, but catalase, nitrate reduction to nitrite, urease, methyl red and β-galactosidase were positive, It was nonlactose fermenting, but produced acid without gas from arabinose, esculin,
glucose,
maltose, mannitol, mannose, rhamnose, salicin and xylose. The result of antimicrobial susceptibility test was sensitive to amikacin, ampicillin, carbenicillin, cephalothin, cephotaxime, chloramphenicol, ciprofloxacin, gentamycin, kanamycin.
nalidixic
acid, neomycin, norfloxacin, oxacillin, penicillin, polymyxin, B, streptomycin, tetracycline, tobramycin, sulfamethoxazole with trimethoprim, and vancomycin except resistant to erythromycin.
In conclusion, although, Y. pseudotuberculosis infection may not common in Korea, effort to isolate the organism from the clinical specimens and further epidemic study of healthy carrier animals should be necessary.
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