|Campylobacter jejuni & C.
Organisms: motile, non-spore-forming Gram-negative rods. They
are a common cause of bacterial diarrheal disease (C.jejuni) &
systemic infection (C.fetus).
Mode of transmission: contamination of milk & other animal
food sources, or direct conta t with infected animals & contaminated
Most cases occur 2-4 days after exposure. Bacteremia is rare in C.jejuni
C.jejuni illness typically presents with a prodrome of fever, headache,
myalgia, & malaise for up to 24 hours before intestinal Sx develop.
The fever may be as high as 40oC (104oF),
& diarrhea varies from a few loose stools to copious watery discharge.
Blood is frequently present in the stool but varies in amount. The
illness usually lasts less than a week, but the untreated pts may excrete
the organisms for several weeks.
C.fetus illness frequently produces systemic disease, often in
vascular sites: endocarditis, pericarditis, & mycotic aneurysms
of the abdominal aorta. CNS infections such as meningoencephalitis
also occur, as do other localized infections including septic arthritis,
spontaneous bacterial peritonitis, salpingitis, lung abscess, empyema,
cellulitis, UTI, vertebral osteomyelitis, & cholecystitis. In pts
with the AIDS, campylobacter spp. other than C. fetus & C.jejuni may
also cause bacteremia.
Presumptive Dx of Campylobacter jejuni infection may be made by examination
of stool passed within 2 hours using direct dark-field or phase-contrast
microscopy. Leukocytes & red cells are also frequently seen in
Confirmation of the C.jejuni infection is based on a positive stool or blood
DNA proves, PCR, & serologic testing have all been used to confirm diagnosis
but are not routinely available.
C. fetus may be isolated from blood held in culture up to 14 days.
The fastidious nature of the organisms means that failure to culture
Campylobacter does not rule them out as the cause of significant clinical
Fluid replacement in diarrheal patients.
Mild & self-limited campylobacter infections do not require specific
treatment. Antibiotics are recommended only for patients with severe
infection, including those with significant fever or volume loss, frequent
bloody diarrhea, prolonged or severe symptoms, & for the immunocompromised
Antibiotics: Erythromycin 500 mg PO
qid x 1 wk, tetracyclines, aminoglycosides, chloramphenicol,
quinolones (as (Ciprofloxacin 500 mg PO bid x 1
wk), nitrofurans, & clindamycin. Extraubtestubak
ubfectuib wutg C.jejuni needs at least 10 days of Rx, and systemic C.fetus
infection warrants 2-3 wks of therapy.