Campylobacter and related infections


  • Campylobacter infections typically cause self-limited diarrhea but occasionally cause bacteremia, with consequent endocarditis, osteomyelitis, or septic arthritis. Diagnosis is by culture, usually from stool. Treatment when needed includes azithromycin .
    Campylobacter species are motile, curved, microaerophilic, gram-negative bacilli that normally inhabit the gastrointestinal tract of many domestic animals and fowl.
    Several species are human pathogens. The major pathogens are C. jejuni and C. fetus.
    C. jejuni is a common food-borne pathogen that affects healthy and compromised people. It causes diarrhea in all age groups, although peak incidence appears to be from age 1 to 5 years. C. jejuni accounts for more cases of diarrhea in the US than Salmonella and Shigella combined. C. jejuni can cause meningitis in infants.
    C. fetus and several others typically cause bacteremia and systemic manifestations in adults, more often when underlying predisposing diseases, such as diabetes, cirrhosis, cancer, or HIV/AIDS, are present. C. fetus is much less common than C. jejuni and is usually an opportunistic pathogen affecting people with underlying disease, older people, and pregnant women. In pregnant patients, the rate of fetal loss can be as high as 70%. C. fetus infections in healthy hosts occur in those with occupational exposure to infected animals. In patients with immunoglobulin deficiencies, these organisms, including C. jejuni, may cause difficult-to-treat, relapsing infections.
    The following have been implicated in outbreaks:

    Contact with infected animals (eg, puppies)
    Contact with contaminated food or water (eg, handling contaminated food)
    Ingestion of contaminated food (especially undercooked poultry) or water

    Person-to-person transmission through fecal-oral and sexual contact may also occur but is uncommon because a large number of Campylobacter organisms are required to cause infection. Transmission of Campylobacter infection does occur among men who have sex with men. However, in sporadic cases, the source of the infecting organism is frequently obscure.


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