[Diagnosis and therapeutic pitfalls in systemic yersiniosis (Yersinia enterocolitica)].
Yersinioses (Y. enterocolitica 0:3) account in the North Moravian region for 1.3% of all notified diarrhoeal diseases of bacterial origin. Since 1989 the authors recorded in samples of faeces and tissue biopsies 65 strains of Y.e. and by cold cultivation 47 strains of Y.e. In 48 systemic yersinioses the dynamics of specific antibodies were investigated by the method of passive haemagglutination. The authors produce the antigen from a pure culture of a strain of Y.e. from their collection. To test the level of specific titres they examined healthy controls. If titres of 1:640 or higher persist for some time, as a rule extraintestinal forms with a protracted course and with relapses are involved. The joints were affected most frequently (70%), mostly in women. High antibody titres were found also in articular exudates obtained by puncture. Subjects with HIA-B27 are a risk group. Usually a prolonged course of treatment with cotrimoxazole proved successful. Only in one instance with a protracted course and relapses, after a series of preparations was tested, mostly quinolones, synovectomy was performed. The authors assume that some cases of systemic yersinioses are not properly diagnosed. Usually it does not proved possible to elucidate the source of infection, although in some instances the disease has a clearly occupational character.