# Yersinia Enterocolitica Infection - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - ORS — oral.solution - Referral & safety-netting (no drug therapy) - Ciprofloxacin — 500 mg — oral.solid ## Complete treatment card ```text YERSINIA ENTEROCOLITICA INFECTION 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 Review status: REVIEWED against 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) (2026-08) 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 Source StatPearls "Yersinia enterocolitica Infection" - disease-level clinical article Status traced to the source above 1. ORS [1st line] Adult 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 Peds 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. (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.) 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. Caution 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). Egypt GLUCOHYDRAN 10 SACHET. ARAB DRUG COM... 1.75 EGP REHYDRAN N 10 SACHET CID 4.50 EGP REHYDRO ZINC 10 SACHETS CID 7.00 EGP ORS 20 SACHETS PHAROPHARMA 40.00 EGP ELECTRO MASH SYRUP 200 ML MASH PREMIERE 60.00 EGP FLEXOLYTE ORAL REHYDRATION SOL. 240 ML KEMPETRO FOR CHEMICAL INDUSTRIES 65.00 EGP HERO ORS 200 ML HERO > HERO M... 120.00 EGP SANSO ORS SYRUP 140 ML AUG PHARMA 400.00 EGP 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. Caution 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] Adult 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. Peds 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.) 3kg -> 30 mg/dose 4kg -> 40 mg/dose 5kg -> 50 mg/dose 6kg -> 60 mg/dose 7kg -> 70 mg/dose 8kg -> 80 mg/dose 9kg -> 90 mg/dose 10kg -> 100 mg/dose 11kg -> 110 mg/dose 12kg -> 120 mg/dose 13kg -> 130 mg/dose 14kg -> 140 mg/dose 15kg -> 150 mg/dose 16kg -> 160 mg/dose 17kg -> 170 mg/dose 18kg -> 180 mg/dose 19kg -> 190 mg/dose 20kg -> 200 mg/dose 21kg -> 210 mg/dose 22kg -> 220 mg/dose 23kg -> 230 mg/dose 24kg -> 240 mg/dose 25kg -> 250 mg/dose 26kg -> 260 mg/dose 27kg -> 270 mg/dose 28kg -> 280 mg/dose 29kg -> 290 mg/dose 30kg -> 300 mg/dose 31kg -> 310 mg/dose 32kg -> 320 mg/dose 33kg -> 330 mg/dose 34kg -> 340 mg/dose 35kg -> 350 mg/dose 36kg -> 360 mg/dose 37kg -> 370 mg/dose 38kg -> 380 mg/dose 39kg -> 390 mg/dose 40kg -> 400 mg/dose 41kg -> 410 mg/dose 42kg -> 420 mg/dose 43kg -> 430 mg/dose 44kg -> 440 mg/dose 45kg -> 450 mg/dose 46kg -> 460 mg/dose 47kg -> 470 mg/dose 48kg -> 480 mg/dose 49kg -> 490 mg/dose 50kg -> 500 mg/dose AWaRe WATCH group - carries resistance cost. Egyptian EML 2025. 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. Caution 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. Egypt QUINOLOROX 500MG 10 F.C. TAB. EPCI > ROXXEN 10.00 EGP (1.00/unit) ECACIPROFLOX 500 MG 20 F.C. TABS. FUTURE PHARMACEUTICAL INDU... 27.00 EGP (1.35/unit) ELMODOXACIN 500MG 10 F.C.TAB. EGPI > SEA PHARM 20.00 EGP (2.00/unit) CIPROQUIN 500MG 10 F.C. TAB. UNIPHARMA 50.00 EGP (5.00/unit) CIPROFLOXACIN-ORGANO 500 MG 10 F.C.TABS. ORGANOPHARMA > ORGANO 63.00 EGP (6.30/unit) CIPROFAR 500MG 10 F.C.TAB. PHARCO 69.00 EGP (6.90/unit) CIPROMEGA XL 500MG 10 EXT. REL. F.C.TABS. MASH PREMIERE 48.00 EGP HEROXACIN 500MG 10 SCORED F.C. TAB. EGPI > HERO PHARM 69.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)