Campylobacter jejuni

Aka: Campylobacter jejuni, Campylobacteriosis

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II. Epidemiology

  1. Responsible for 5-14% of worldwide Diarrhea
  2. Very common in Southeast asia

III. Pathophysiology

  1. Natural Hosts: Wild birds and ducks
  2. Foodborne Illness
    1. Gastroenteritis (sporadic cases are common)
    2. Outbreaks (e.g. unpasteurized milk)
  3. Diseases caused by Campylobacter jejuni
    1. Traveler's Diarrhea
    2. Waterborne Illness

IV. Risk Factors

  1. Use of prophylactic antibiotics (Traveler's Diarrhea Prevention)

V. Labs

  1. Stool Culture
    1. Very difficult to culture
    2. Requires selective growth medium (Campy Blood Agar)
  2. Darkfield microscopy
  3. Phase contrast microscopy

VI. Symptoms

  1. Course
    1. Onset in 3-5 days
    2. Duration 2-10 days
  2. Prodrome
    1. Headache
    2. Myalgias
    3. Fever
    4. Abdominal Pain
  3. Symptoms vary
    1. Fever occurs in more than half of patients
    2. Mild cases: Asymptomatic excretion
    3. Severe cases: Dysentery (with bloody Diarrhea)
    4. Diarrhea is self limited in immunocompetent hosts

VII. Management: Antibiotics

  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

VIII. Complications

  1. Guillain-Barre Syndrome
  2. Reactive Arthritis

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