- Among the most common causes of Infectious Diarrhea
- Responsible for 5-14% of worldwide Diarrhea
- In some years in the U.S., Campylobacter jejuni may cause 2 million cases of Infectious Diarrhea
- Very common in Southeast asia
- Characteristics
- Campylobacter jejuni is a facultative Anaerobic Gram Negative Rod in Vibrionaceae family
- Like Vibrio species, Campylobacter jejuni is curved, and motile with a single polar flagellum
- Virulence
- Heat labile Enterotoxin (LT)
- Campylobacter jejuni binds and invades intestinal epithelium
- May spread systemically in Immunocompromised hosts
- Similar to Salmonella typhi or Yersinia enterocolitica
- May spread systemically in Immunocompromised hosts
- Sources
- Natural Hosts: Wild birds and ducks (natural reservoir of zoonotic disease)
- Also found in domestic animals including poultry
- Waterborne Illness
- Fecal oral route of contaminated water
- Foodborne Illness
- Gastroenteritis (sporadic cases of Traveler's Diarrhea are common)
- Outbreaks (e.g. unpasteurized milk, esp. in children)
- Natural Hosts: Wild birds and ducks (natural reservoir of zoonotic disease)
- Use of prophylactic Antibiotics (Traveler's Diarrhea Prevention)
- Course
- Onset in 3-5 days
- Duration 2-10 days
- Prodrome
- Low grade fever (>50% of cases)
- Headache
- Myalgias
- Abdominal Pain or cramping
- Watery, bloody Diarrhea (follows prodrome by <1 day)
-
Stool Culture
- Very difficult to culture
- Requires selective growth medium (Campy Blood Agar)
- Darkfield microscopy
- Phase contrast microscopy
-
Antibiotic indications (longer course for Immunocompromised patients)
- Dysentery (Inflammatory Diarrhea)
- Sepsis
- May be indicated in enteritis
- First-line agents
- Azithromycin (Zithromax) 500 mg orally daily for 3 days
- Treat for 14 days if associated with bacteremia (which is rare)
- Alternative agents
- Erythromycin 500 mg orally four times daily for 3 days
- Ciprofloxacin 500 mg orally twice daily for 5 days
- Fluoroquinolone (high resistance rate >50-85%)
- References
- (2016) Sanford Guide to Antimicrobial Therapy, accessed 5/7/2016