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Campylobacter jejuni

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Campylobacter jejuni, Campylobacteriosis, Campylobacter Colitis

  • See Also
  1. Diarrhea
  2. Infectious Diarrhea
  • Epidemiology
  1. Among the most common causes of Infectious Diarrhea
    1. Responsible for 5-14% of worldwide Diarrhea
    2. In some years in the U.S., Campylobacter jejuni may cause 2 million cases of Infectious Diarrhea
    3. Very common in Southeast asia
  • Pathophysiology
  1. Characteristics
    1. Campylobacter jejuni is a facultative Anaerobic Gram Negative Rod in Vibrionaceae family
    2. Like Vibrio species, Campylobacter jejuni is curved, and motile with a single polar flagellum
  2. Virulence
    1. Heat labile Enterotoxin (LT)
    2. Campylobacter jejuni binds and invades intestinal epithelium
      1. May spread systemically in Immunocompromised hosts
        1. Similar to Salmonella typhi or Yersinia enterocolitica
  3. Sources
    1. Natural Hosts: Wild birds and ducks (natural reservoir of zoonotic disease)
      1. Also found in domestic animals including poultry
    2. Waterborne Illness
      1. Fecal oral route of contaminated water
    3. Foodborne Illness
      1. Gastroenteritis (sporadic cases of Traveler's Diarrhea are common)
      2. Outbreaks (e.g. unpasteurized milk, esp. in children)
  • Risk Factors
  1. Use of prophylactic Antibiotics (Traveler's Diarrhea Prevention)
  • Symptoms
  1. Course
    1. Onset in 3-5 days
    2. Duration 2-10 days
  2. Prodrome
    1. Low grade fever (>50% of cases)
    2. Headache
    3. Myalgias
    4. Abdominal Pain or cramping
  3. Watery, bloody Diarrhea (follows prodrome by <1 day)
    1. Diarrhea is self limited in immunocompetent hosts
    2. Mild cases: Asymptomatic excretion
    3. Severe cases: Dysentery (with bloody Diarrhea)
  • Labs
  1. Stool Culture
    1. Very difficult to culture
    2. Requires selective growth medium (Campy Blood Agar)
  2. Darkfield microscopy
  3. Phase contrast microscopy
  1. Antibiotic indications (longer course for Immunocompromised patients)
    1. Dysentery (Inflammatory Diarrhea)
    2. Sepsis
    3. May be indicated in enteritis
  2. First-line agents
    1. Azithromycin (Zithromax) 500 mg orally daily for 3 days
    2. Treat for 14 days if associated with bacteremia (which is rare)
  3. Alternative agents
    1. Erythromycin 500 mg orally four times daily for 3 days
    2. Ciprofloxacin 500 mg orally twice daily for 5 days
      1. Fluoroquinolone (high resistance rate >50-85%)
  4. References
    1. (2016) Sanford Guide to Antimicrobial Therapy, accessed 5/7/2016
  • Complications
  1. Guillain-Barre Syndrome
  2. Reactive Arthritis
  • References
  1. Kaakoush (2015) Clin Microbiol Rev 28(3):687-720 +PMID: 26062576 [PubMed]