174.2 📚 國考版

174.2.0.1 必背 — 細菌學

• Gram - rod, cold-tolerant 4°C
• Bipolar staining (safety pin like family)
• Urease +

174.2.0.2 必背 — Source

• Y. enterocolitica: pork, chitterlings, milk, refrigerated food
• Y. pseudotuberculosis: rodents, vegetable, 日本/東歐

174.2.0.3 必背 — 臨床

• Enteritis (兒童, longer course 1-3 wk, 血便)
• “Pseudoappendicitis” — RLQ pain, mesenteric adenitis, terminal ileitis
• Bacteremia + iron overload + multi-focal abscess (deferoxamine ↑↑ risk!)
• Reactive arthritis (HLA-B27) + erythema nodosum
• Transfusion-associated bacteremia (RBC unit, cold storage)

174.2.0.4 必背 — Treatment

• Healthy enteritis: NO antibiotic
• Severe: ceftriaxone or doxy + gent
• Iron overload: stop deferoxamine, use deferiprone / deferasirox

174.2.0.5 必背 — Pseudoappendicitis Tip

• 青少年 RLQ pain + 燒 + 短 diarrhea hx → 鑑別 Yersinia from acute appendicitis (CT may help)

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