ID

Campylobacter jejuni

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Campylobacter jejuni, Campylobacteriosis

  • Epidemiology
  1. Responsible for 5-14% of worldwide Diarrhea
  2. Very common in Southeast asia
  • 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
  • Risk Factors
  1. Use of prophylactic antibiotics (Traveler's Diarrhea Prevention)
  • Labs
  1. Stool Culture
    1. Very difficult to culture
    2. Requires selective growth medium (Campy Blood Agar)
  2. Darkfield microscopy
  3. Phase contrast microscopy
  • 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
  • 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