Comments
INITIAL SYMPTOMS:
Acute gastroenteritis, often with bloody diarrhea; [CCDM]
FINDINGS:
Symptoms usually resolve within a week, but some adults have a prolonged course that mimics inflammatory bowel disease. Complications include Reiter's syndrome (~1% of cases) and Guillain-Barre syndrome (~0.1% of cases). [CCDM, p. 85] Guillain-Barre syndrome develops in up to 30% of patients with C. jejuni diarrheal illness. [Merck Manual, p. 1247] Toxic megacolon may complicate severe infections. Some patients present with abdominal pain and pseudoappendicitis. Meningitis and endocarditis are rare complications. [PPID, p. 2489] C. jejeuni can grow in bile and cause cholecystitis and pancreatitis. [Cohen, p. 1730] Other complications are reactive arthritis, uveitis, hemolytic-uremic syndrome, erythema nodosum, encephalitis, and carditis. [Cecil, p. 1870]
EPIDEMIOLOGY:
Outbreaks have been associated with the ingestion of unpasteurized milk, undercooked poultry, and contaminated water. Reservoirs include poultry, cattle, puppies, kittens, swine, sheep, rodents, and birds. [CCDM, p. 86] Also primates; [PPID 7th Ed., p. 4002] "Sexually acquired proctocolitis is most often due to Campylobacter or Shigella species." [Harrison, p. 558] "The risk of infection is highest in travelers to Africa and South America, especially in areas with poor restaurant hygiene and inadequate sanitation." [CDC Travel, p. 149]
RELATED INFECTION:
About 99% of Campylobacter infections are caused by C. jejuni. [ABX Guide] Campylobacter fetus may also cause diarrhea, but it is an opportunistic infection that is usually isolated from the blood. Clinical manifestations of C. fetus infections include meningoencephalitis, mycotic aneurysms, cellulitis, abscesses, cholecystitis, septic arthritis, and osteomyelitis. [PPID, p. 2490] C. fetus may cause a prolonged relapsing illness in compromised hosts. It often infects vascular sites (endocarditis, mycotic aneurysms, and septic thrombophlebitis). Infection in pregnancy may cause fetal death. [Harrison ID, p. 581]
For updated text and symptoms of infectious diseases, see iddx.com.
Diagnostic
Stool culture on selective media & at 42 deg C (special lab request); [ABX Guide] Confirm rapid stool Ag tests with culture; [CDC Travel] Phase contrast or darkfield to identify motile, S-shaped rods; Antibody-based and PCR testing available; [CCDM]