Positive Yersinia Serology and Colonic Cobblestone Pattern: A Diversion or Main Culprit?

Abstract

Yersinia enterocolitica infection, the third most prevalent gastrointestinal infection in Europe, poses a diagnostic challenge due to its resemblance to other common conditions such as acute appendicitis, Crohn's disease, and malignancy. We report the case of a 48-year-old female patient who sought medical attention for abdominal pain and diarrhoea. Her endoscopic examination revealed a cobblestone pattern affecting the entire colon, more pronounced in the right colon, but with normal mucosa in the terminal ileum. This unique presentation created a challenge in distinguishing Yersiniosis from Crohn's disease. This case report aimed to highlight this atypical endoscopic manifestation of Y. enterocolitica infection. We underline the subacute nature of the symptoms, which can last up to 4-6 weeks. This reinforces the importance of considering Y. enterocolitica infection as a diagnostic possibility, even when the endoscopic appearance closely resembles other chronic intestinal diseases.