Dawaa Reference

acute

Yersinia Enterocolitica Infection

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

Egyptian National Drug Formulary - Antimicrobial 2023, Ciprofloxacin monograph, PDF page index 373-374 (printed p364-365). The formulary lists "infectious diarrhea" as an adult indication but attaches no dose to it; the 500 mg every 12 hours figure is taken from its nontyphoidal Salmonella GI regimen. There is no shigellosis, campylobacter or Yersinia enterocolitica regimen in this monograph. · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Verified against3 documents
  • Egyptian National Drug Formulary - Antimicrobial 2023, Ciprofloxacin monograph, PDF page index 373-374 (printed p364-365). The formulary lists "infectious diarrhea" as an adult indication but attaches no dose to it; the 500 mg every 12 hours figure is taken from its nontyphoidal Salmonella GI regimen. There is no shigellosis, campylobacter or Yersinia enterocolitica regimen in this monograph.
  • WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2
  • Yersinia enterocolitica Infection - disease-level clinical article (yersiniosis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • Fever and abdominal pain that progress to nausea, vomiting, and diarrhea, sometimes bloody [abdominal pain · diarrhoea · fever · nausea · vomiting]
  • Right lower quadrant pain that can mimic appendicitis [abdominal pain · right lower quadrant pain]
  • Shedding of the organism in stool often continues after symptoms have resolved

Signs — what you find (3)

  • Reactive arthritis afterward is aseptic and asymmetric, mainly affecting the legs
  • Tender red nodules on the skin can show up 2 to 14 days after the belly pain starts [abdominal pain · skin nodule]
  • Sepsis occurs in infants, older adults, and immunocompromised or iron-overloaded patients, with roughly a 50 percent fatality rate [sepsis]

Tests (6)

  • Stool culture confirms the diagnosis but must be specifically requested, since many labs do not test for it routinely
  • A negative stool culture does not rule out the infection because false negatives are frequent
  • Imaging such as ultrasound, CT, or MRI helps tell true appendicitis apart from Yersinia pseudoappendicitis
  • MRI can show inflammation of the terminal ileum with a normal-looking appendix
  • Colonoscopy, when done, may show aphthous lesions and ulcers in the terminal ileum, usually on the right side
  • Serologic antibody tests for IgG, IgA, and IgM are used more in Japan and Europe than in the US

If not this — what else fits (6)

  • Other infectious causes of diarrhea - viral, bacterial, protozoal, or fungal - need to be excluded
  • Inflammatory bowel disease is on the differential
  • Diverticulitis is also considered
  • True appendicitis must be distinguished from Yersinia-related pseudoappendicitis
  • Medication-associated colitis is on the differential
  • In developing countries, HIV, influenza, dengue, or malaria should also be considered

SourceStatPearls "Yersinia enterocolitica Infection" - disease-level clinical article

Presentation findings are traced to the source above.

1

ORS

1st line

Formoral.solution

Adult dose and duration

Plan A (no dehydration): Drink as much ORS solution / fluid as desired after each loose stool. Plan B (some dehydration): 2,200 to 4,000 mL of ORS solution over the first 4 hours (up to 750 mL/hour), then reassess. - Until diarrhoea stops

Paediatric dose

(Plan B (some dehydration): give the child's weight in kg x 75 mL of ORS solution in the first 4 hours, then reassess. Plan A (no dehydration): 50-100 mL after each loose stool under 2 years, 100-200 mL from 2 to 10 years.)

Dose by age
Under 2 years:50 to 100 mL of ORS after each loose stool (Plan A, no dehydration). With some dehydration, Plan B is by weight at any age.
2 to 10 years:100 to 200 mL of ORS after each loose stool (Plan A, no dehydration). With some dehydration, Plan B is by weight at any age.
Dose source

WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Why

Supportive rehydration is the mainstay of treatment for the typically self-limiting course of Yersinia enterocolitis.

Cautions
  • Most Yersinia enteritis is self-limiting and needs only supportive rehydration.
  • Assess hydration status regularly, particularly in children.
  • Look for right lower quadrant pain mimicking appendicitis, high fever, signs of bloodstream infection, or joint pains appearing after the diarrhoea (reactive arthritis).
Egyptian brands
Egyptian brandManufacturerIndicative price
GLUCOHYDRAN 10 SACHET.ARAB DRUG COMPANY (ADCO)1.75 EGP
REHYDRAN N 10 SACHETCID4.50 EGP
REHYDRO ZINC 10 SACHETSCID7.00 EGP
ORS 20 SACHETSPHAROPHARMA40.00 EGP
ELECTRO MASH SYRUP 200 MLMASH PREMIERE60.00 EGP
FLEXOLYTE ORAL REHYDRATION SOL. 240 MLKEMPETRO FOR CHEMICAL INDUSTRIES65.00 EGP
HERO ORS 200 MLHERO > HERO MEA TRADING120.00 EGP
SANSO ORS SYRUP 140 MLAUG PHARMA400.00 EGP
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Yersinia enterocolitica Infection - disease-level clinical article (yersiniosis-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Antimotility agents are explicitly advised against as they may worsen the infection.
  • RED FLAG - The risk factors for severe Yersinia infection requiring antibiotic therapy are iron overload, immunocompromised status, and advanced age.
3

CIPROFLOXACIN

2nd line

Strength500 mg

Formoral.solid

Adult dose and duration

500 mg by mouth every 12 hours. x 3 to 14 days - the formulary's range for nontyphoidal Salmonella GI infection. It gives no duration for shigellosis, campylobacter or yersiniosis.

Paediatric dose

10 mg/kg/dose [child max 500 mg]

(Formulary general paediatric dosing for mild to moderate infection: 10 mg/kg per dose twice daily by mouth (immediate release), maximum 500 mg per dose. The formulary's 15 to 20 mg/kg per dose figure is for severe infection and carries a 750 mg per- dose maximum - do not pair 15 mg/kg with a 500 mg cap. Ciprofloxacin is not first-line in children and the formulary gives no paediatric enteric-infection regimen.)

Dose by weight
3kg30 mg/dose
4kg40 mg/dose
5kg50 mg/dose
6kg60 mg/dose
7kg70 mg/dose
8kg80 mg/dose
9kg90 mg/dose
10kg100 mg/dose
11kg110 mg/dose
12kg120 mg/dose
13kg130 mg/dose
14kg140 mg/dose
15kg150 mg/dose
16kg160 mg/dose
17kg170 mg/dose
18kg180 mg/dose
19kg190 mg/dose
20kg200 mg/dose
21kg210 mg/dose
22kg220 mg/dose
23kg230 mg/dose
24kg240 mg/dose
25kg250 mg/dose
26kg260 mg/dose
27kg270 mg/dose
28kg280 mg/dose
29kg290 mg/dose
30kg300 mg/dose
31kg310 mg/dose
32kg320 mg/dose
33kg330 mg/dose
34kg340 mg/dose
35kg350 mg/dose
36kg360 mg/dose
37kg370 mg/dose
38kg380 mg/dose
39kg390 mg/dose
40kg400 mg/dose
41kg410 mg/dose
42kg420 mg/dose
43kg430 mg/dose
44kg440 mg/dose
45kg450 mg/dose
46kg460 mg/dose
47kg470 mg/dose
48kg480 mg/dose
49kg490 mg/dose
50kg500 mg/dose
AWaRe

WATCH group - carries resistance cost. Egyptian EML 2025.

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023, Ciprofloxacin monograph, PDF page index 373-374 (printed p364-365). The formulary lists "infectious diarrhea" as an adult indication but attaches no dose to it; the 500 mg every 12 hours figure is taken from its nontyphoidal Salmonella GI regimen. There is no shigellosis, campylobacter or Yersinia enterocolitica regimen in this monograph.

Why

Antibiotic reserved for severe or systemic Yersinia infection; the same short empiric course used for other bacterial dysenteries applies.

Cautions
  • Not routinely first-line in children (formulary note).
  • The only Yersinia entry in this monograph is plague (Yersinia pestis), a different organism from the yersiniosis on this row - that condition has no formulary support here.
  • The formulary reserves this enteric regimen for severe illness or patients at high risk of invasive disease.
  • Reserve for severe, prolonged, or systemic illness (fever, bacteraemia, or symptoms mimicking appendicitis) - most cases do not need it.
  • Tendinitis/tendon rupture, QT prolongation, and glycaemic swings are class risks.
  • If right lower quadrant pain is prominent, coordinate with surgery to exclude true appendicitis before treating empirically.
Egyptian brands
Egyptian brandManufacturerIndicative price
QUINOLOROX 500MG 10 F.C. TAB.EPCI > ROXXEN10.00 EGP (1.00/unit)
ECACIPROFLOX 500 MG 20 F.C. TABS.FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > EGYPTIAN CANADIAN PHARMACEUTICAL27.00 EGP (1.35/unit)
ELMODOXACIN 500MG 10 F.C.TAB.EGPI > SEA PHARM20.00 EGP (2.00/unit)
CIPROQUIN 500MG 10 F.C. TAB.UNIPHARMA50.00 EGP (5.00/unit)
CIPROFLOXACIN-ORGANO 500 MG 10 F.C.TABS.ORGANOPHARMA > ORGANO63.00 EGP (6.30/unit)
CIPROFAR 500MG 10 F.C.TAB.PHARCO69.00 EGP (6.90/unit)
CIPROMEGA XL 500MG 10 EXT. REL. F.C.TABS.MASH PREMIERE48.00 EGP
HEROXACIN 500MG 10 SCORED F.C. TAB.EGPI > HERO PHARM69.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.