Campylobacter jejuni

Aka: Campylobacter jejuni, Campylobacteriosis

1. See Also
   1. Diarrhea
   2. Infectious Diarrhea
2. Epidemiology
   1. Responsible for 5-14% of worldwide Diarrhea
   2. Very common in Southeast asia
3. 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
4. Risk Factors
   1. Use of prophylactic antibiotics (Traveler's Diarrhea Prevention)
5. Labs
   1. Stool Culture
      1. Very difficult to culture
      2. Requires selective growth medium (Campy Blood Agar)
   2. Darkfield microscopy
   3. Phase contrast microscopy
6. 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
7. 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
8. Complications
   1. Guillain-Barre Syndrome
   2. Reactive Arthritis