Symptoms and treatment of pseudo-tuberculosis in children

Due to its confusing name, pseudo-tuberculosis is an infectious disease that can afflict children. Pseudo-tuberculosis primarily affects the digestive system, as opposed to tuberculosis, which primarily affects the lungs. It can also mimic symptoms of other common illnesses. It is imperative that parents and caregivers comprehend its symptoms and know how to react.

*Yersinia pseudotuberculosis* is the bacteria that causes this disease, and it is frequently found in tainted food, water, or soil. Children can contract the disease through close contact with infected animals, consumption of undercooked meat, and unwashed vegetables. Although it is less frequent than other pediatric infections, being aware of the symptoms can aid in treatment and early detection.

Pseudo-tuberculosis symptoms can range greatly, from mild to severe, and they frequently mimic those of the flu, appendicitis, or scarlet fever. Fever, rashes, stomach pain, and enlarged lymph nodes are typical symptoms. Given the overlap of these symptoms with other conditions, a medical professional’s accurate diagnosis is crucial.

In order to avoid complications, prompt treatment is essential. Symptom management, supportive care, and antibiotics may be necessary, depending on the severity. Acquiring knowledge about pseudo-tuberculosis and its available treatments facilitates timely intervention and guarantees your child’s quick recovery.

Symptoms	Treatment
Fever and chills	Rest and plenty of fluids
Abdominal pain	Pain relievers as prescribed by a doctor
Skin rash	Topical creams for itching relief
Joint pain	Anti-inflammatory medications
Nausea and vomiting	Anti-nausea medications
Diarrhea	Hydration and electrolytes

What is it?

Other names for pseudotuberculosis include extraintestinal yersiniosis and Far Eastern scarlet fever-like fever. The enterobacterium Yersiniae pseudotuberculosis is the cause of the illness. It truly produces symptoms in children that are comparable to those of the majority of influenza and acute respiratory viral infections, including fever, rash, muscle and joint pain, and respiratory symptoms. Serious side effects such as kidney failure, pneumonia, and inflammation of the heart lining can occasionally result from the illness.

Roughly 10,000 Russians contract pseudo-tuberculosis annually; the majority of these patients are younger than 14 years old.

Typically, the illness peaks in the winter and early spring. In addition to humans, enterobacteria also infects mice and other rodents, as well as horses, cows, and goats. The primary thought carriers of the bacteria are rodents.

Causes

Infection occurs through the mouth, with dirty hands, with food that has been contaminated with microbes. They are quite resistant and hardy – they cannot be killed in boiling water, in open sunlight, or when treated with disinfectant solutions. Enterobacterium Yersiniae pseudotuberculosis survives well in the refrigerator on food. Many people mistakenly believe that if there are no mice or rats in the house, then infection does not threaten a child or an adult. The presence of mice is not required. Rodents infect soil, water, vegetables and fruits with enterobacteria in the place where they grow. And contaminated food and water then end up in people"s apartments. The bacteria lives in water for up to 8 months, and in soil – up to a year.

Unsanitary meat, vegetable, and fruit preparations, as well as dairy products, can potentially spread the infection of pseudotuberculosis. The most hazardous months are winter and early spring, when people start purchasing and consuming veggies that have been kept in vegetable storage facilities for several months. Under these circumstances, enterobacteria are seeded and perfectly retain their aggressive characteristics. The bacteria enter the stomach and proceed to the ileum, where they produce inflammation. After then, the lymph nodes start to become infected. When enterobacteria’s toxins enter a child’s bloodstream during their life cycle, symptoms manifest.

The liver and spleen suffer if the pathological process intensifies. It takes several days for a child’s natural defenses to generate the required antibodies and start killing microbes, which is why the immune response takes so long to develop. Re-infection is possible because immunity is not permanent.

The incubation period in children is typically 8–10 days, but it can take up to 20 days from the time bacteria enter the mouth until the intoxication phase manifests.

Types of disease

• Abdominal. This type is manifested by enterocolitis, often resembling appendicitis.
• Arthralgic. With this type of pseudo-tuberculosis, joints hurt, fever is combined with manifestations of polyarthritis.
• Scarlet fever-like. This type of disease manifests itself with a rash very similar to the rash with scarlet fever.
• Mixed. Can combine the signs and symptoms of all types of pseudo-tuberculosis.
• Septic. The type of disease is associated with the development of toxic shock.

The disease can be classified as mild, moderate, severe, complicated, or uncomplicated.

Symptoms and signs

The most common scenario for the development of pseudo-tuberculosis in children is a localized form of the illness. Every time the disease manifests, there is an abrupt rise in body temperature to 38.0–39.0 degrees.

The young person reports having stomach pain and chills. He might throw up. Frequent and loose stools occur. The infant can run ten or twelve times a day to the bathroom.

The excrement has an extremely disagreeable smell, a foamy structure, and a greenish tint. If they contain large pieces of mucus or blood, this could mean that the large intestine has been affected by the lesion.

They may seem slightly swollen and develop joint pain after a few hours or a day. At about the same time, reaching its peak on the third day, a rash that resembles scarlet fever develops; it takes the form of tiny nodules.

The following symptoms are indicative of the child’s condition:

• severe headache;
• weakness and intoxication;
• dehydration is possible;
• the tongue is covered with a white coating, after 14 days the coating becomes crimson;
• redness with a slight cyanosis of the hands, feet, face is observed;
• sometimes pain in the iliac region on the right;
• enlarged lymph nodes.

There is neither vomiting nor diarrhea when pseudo tuberculosis is arthralgic. There is a fever and pain in the joints. There may or may not be a rash associated with the condition.

When the illness starts to manifest itself widely, the body temperature increases to 40.0 degrees, vomiting starts, and a rash appears almost instantly.

The disease’s septic form is thought to be the most serious.

The immune system functions "at the limit" in infants and young children with chronic illnesses; it is insufficient on its own.

Septic pseudotuberculosis is characterized by a fever exceeding 40.0 degrees, profuse sweating, and potential unconsciousness in the child. He becomes anemic very rapidly. About 40% of cases of this kind of illness result in death.

In the early stages of any disease, runny nose, coughing, and sore throat are common respiratory symptoms. Any disease will always cause the rash to appear on the lower abdomen, armpits, and sides. Rashes around the joints tend to be larger. The body rash persists for approximately seven days.

The child will feel better and the disease’s symptoms will start to lessen after five to six days if the illness is simple and progresses quickly. The temperature drops smoothly and gradually first, followed by the disappearance of intoxication symptoms, and finally, the joints stop hurting, the swelling goes down, and the lymph nodes swell to normal sizes. A child may require up to 1.5 months to recover from a complex illness, and up to 3 months to recover from a rapid re-infection.

Diagnostics

Four symptoms—fever, rash, joint pain, and gastrointestinal tract issues—should work together to help the doctor determine the right diagnosis. When the first symptoms listed above manifest, a physician needs to be summoned to the residence. A pediatrician may suspect pseudo-tuberculosis, but only a laboratory technician, who will perform all the necessary tests, can confirm the diagnosis.

A sputum sample, urine, throat swab, and stool sample are given to the child for bacterial culture. You can get a sample of the pathogen by growing it on specific nutrient media and testing its antibiotic sensitivity. To choose the best medication for treatment, this information is required.

A blood test for the presence of antibodies to viral infections will undoubtedly be performed because the clinical picture of pseudotuberculosis is very similar to that of measles, scarlet fever, rubella, acute respiratory viral infections, and intestinal infections.

If the doctor recommends hospitalization, at least for a day, don’t freak out. The truth is that if symptoms are ignored, a pathology like appendicitis may go unnoticed, necessitating immediate surgical intervention. A child can have a laparoscopic diagnosis performed in a hospital setting.

Children’s pseudo-tuberculosis is a bacterial infection that can be difficult to diagnose because its symptoms can resemble those of other illnesses. Fever, rash, abdominal pain, and joint pain are typical symptoms that are frequently confused with appendicitis or scarlet fever. To avoid complications and hasten recovery, early detection and appropriate antibiotic treatment are essential. When their child exhibits symptoms, parents should be aware of the symptoms and get help right away because treating pseudo-tuberculosis in a timely manner is essential to its successful management.

Treatment

The primary risk of childhood pseudo-tuberculosis is the potential for severe dehydration. A state of dehydration can occur within a few hours if there is a high temperature along with frequent vomiting and diarrhea. This poses a grave risk to children, particularly infants.

Parents should give their children lots and lots of warm water, tea, and fruit drinks to prevent dehydration. Try giving the child tiny doses from a disposable syringe if vomiting keeps them from drinking, if every sip triggers a new bout of nausea, or if they adamantly refuse to drink.

In the event that this is not feasible, you should dial an ambulance right away. Medical professionals can then administer intravenous saline and glucose infusions to the child in order to make up for the fluid loss.

The child should be given oral rehydration agents such as "Smecta," "Regidron," "Humana Electrolyte," and others while they are in the acute intoxication stage. Strict bed rest, body temperature monitoring, and antipyretic medication are required from the initial symptoms of a fever. Since febrile seizures can occur during the acute phase as well, parents should be prepared to offer emergency care.

The child cannot be forced to eat. However, you should only offer dietary food—porridge, vegetable soup with crackers, and jelly—if he asks for food on his own. Dairy products, smoked and marinated foods, and spicy and salty foods should all be avoided.

Antibiotics are not necessary for treating mild cases of pseudo-tuberculosis. Recuperation can be accomplished by giving the child manageable home care, such as lots of fluids and pureed food; the immune system will take care of the rest when it develops enough required antibodies to the enterobacteria that have penetrated.

Antibiotics are necessary for both moderate and severe forms of the disease. The child is typically prescribed one of the penicillin antibiotics.

The child’s body accepts them the easiest. If the bacteria exhibit resistance to penicillin in laboratory settings or are ineffective against it, the physician may suggest medications belonging to the tetracycline class of antimicrobial agents.

Enterobacteria exhibit high sensitivity to aminoglycoside antibiotics, such as "Neomycin" and "Gentamicin." However, if such a prescription is given unexpectedly, parents ought to decline it. These antibiotics are ototoxic, meaning that children who take them may develop partial hearing loss or total permanent deafness. Hearing does not return when the course of treatment is over.

Depending on the kind of disease and how it progresses, the recommended duration of treatment for pseudo-tuberculosis is seven to fourteen days.

Doctors frequently advise non-steroidal anti-inflammatory medications, like Ibuprofen, for joint pain. Anti-inflammatory ointments, like Indomethacin, can be administered locally. When treating symptoms, one may use nasal drops that have a vasoconstrictor effect for a runny nose, gargles and antiseptics for the throat, and antipyretics like Ibuprofen and Paracetamol for sore throats. Children should not take aspirin or any other medication containing acetylsalicylic acid due to the risk of Reye’s syndrome.

Enterosorbents, such as Smecta or Enterosgel, are prescribed to treat gastrointestinal symptoms. In the latter stages of the illness, multivitamins may be recommended. A warm scarf or shawl should be worn to provide dry heat to relieve pain in the lymph nodes and joints. Alcohol and/or oil compressors are strictly forbidden.

Children’s pseudo-tuberculosis can be difficult to diagnose because of its varied symptoms, which frequently resemble other common illnesses. Early symptoms such as fever, rash, joint pain, and abdominal pain can be mistaken for appendicitis or scarlet fever. It is essential to identify these symptoms as soon as possible and consult a physician for prompt diagnosis and treatment.

Since pseudo-tuberculosis is a bacterial infection, the mainstay of treatment after diagnosis is the use of antibiotics. The provision of supportive care, which includes rest, adequate nutrition, and hydration, is crucial to recovery. To avoid complications or relapse, it’s critical to carefully follow the doctor’s instructions and finish the entire course of prescribed antibiotics.

As crucial is preventing pseudo-tuberculosis. An infection can be considerably decreased by following good hygiene practices, washing fruits and vegetables thoroughly, and making sure food is safe. To protect their children from this illness, parents and other caregivers should teach them the value of hygiene and be aware of these preventive measures.

In summary, effective management of pseudo-tuberculosis can be greatly aided by knowledge of the illness’s symptoms and available treatments. In order to ensure a healthy recovery and reduce risks for children, early diagnosis, appropriate treatment, and preventive care are essential. To protect your child’s health, be watchful and seek medical advice if you notice any symptoms in them.

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