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Campylobacter Jejuni Infection

Campylobacter jejuni is estimated to be amongst the most important bacteria causing gastroenteritis worldwide, particularly in the developing countries. Consumption of contaminated food and water, undercooked poultry, and dairy products are the main sources of human infection. Diarrhea accompanied by cramping, abdominal pain, and fever are the main symptoms. A number of complications may be seen with Campylobacter jejuni infection, one of them being Guillain-Barré syndrome. Microbiological confirmation is vital in the diagnostic workup.


Presentation

Campylobacter jejuni is known for its rather important role in the pathogenesis of gastrointestinal infections. It is described as one of the main causes of acute gastroenteritis in all parts of the world [1] [2] [3] [4] [5]. In the United States and the Western world, the infection is more commonly encountered in adults, whereas children under 2 years of age are the main patient population in the developing world [1] [4]. In order for Campylobacter jejuni infection to occur, humans must ingest this microorganism from contaminated animal products, such as undercooked or raw meat (poultry, beef) and dairy products (unprocessed milk) [1] [2] [5] [6]. However, consumption of contaminated water, poor hygiene, and sanitation are responsible for the high rate of infection in the African, Asian and Middle-Eastern subcontinents [3] [4]. The clinical presentation of Campylobacter jejuni infection starts approximately 2-3 days after ingestion of bacteria and comprises of non-specific signs such as the acute onset of watery (or sometimes bloody) diarrhea, abdominal cramps, and high-grade fever (>40°C) [1] [3]. Up to 10 or more stools can be expected in typical cases, and the duration of symptoms is usually one week [1] [3], but a prolonged course of the disease with several-week-long complaints is reported in a subset of patients [1]. An array of complications has been described due to Campylobacter jejuni infection, including local spread (cholecystitis, peritonitis, pancreatitis), dissemination of infection into other tissues (meningitis, relapsing septic arthritis, osteomyelitis), or even sepsis [1] [3] [4]. The development of Guillain-Barré syndrome, however, an autoimmune disease of the peripheral nervous system in which weakness and acute flaccid paralysis are seen after C. jejuni infection, is perhaps the most common adverse event [1] [2] [7].

Fatigue
  • One of the most common symptoms associated with Candida is fatigue. While there’s no evidence that Candida causes fatigue, there are a couple of ways in which it could contribute to it.[healthline.com]
  • Some complementary and alternative medicine (CAM) practitioners blame common symptoms such as fatigue, headache and poor memory on overgrowth of the fungus-like organism Candida albicans in the intestines, sometimes called "yeast syndrome."[mayoclinic.org]
  • I’ve seen thousands of patients suffer from digestive issues, fatigue, brain fog, recurring fungal infections, skin problems, mood swings, and more, all caused by Candida overgrowth.[amymyersmd.com]
  • ., fatigue, bloating, eczema, dandruff, sugar cravings, a bad memory. Encouragingly, though, treating an overgrowth is largely a matter of diet.[goop.com]
  • The connection between yeast and the liver explains why many of the symptoms of overgrowth—like irritability, fatigue, and brain fog—are similar to those of an overburdened liver.[mindbodygreen.com]
Malaise
  • Abstract Campylobacter jejuni infection frequently presents as acute enteritis with diarrhoea, malaise, fever and abdominal pain. Vomiting and bloody diarrhoea are reported less frequently.[ncbi.nlm.nih.gov]
  • At first, you may have a 12- to 48-hour period of fever, headache, muscle aches, and malaise (a general feeling of sickness). These early symptoms are followed by crampy abdominal pain and diarrhea, sometimes with nausea and vomiting.[drugs.com]
  • After an incubation period (usually of 2–4 days), the patient develops diarrhea, fever, malaise, and often abdominal cramps and pain.[dx.doi.org]
  • Case Report A 53 year-old African lady with end-stage renal failure secondary to SLE-related glomerulonephritis was admitted to the renal ward from the dialysis unit generally unwell, with pyrexia, general malaise and leg swelling; empirical antibiotic[omicsonline.org]
Disability
  • Neither the peak disability nor the residual one-year disability was different between the C. jejuni- positive and C. jejuni-negative patients. The patients with preceding C. jejuni infection were more likely to have axonal neuropathy (p 0.021).[ncbi.nlm.nih.gov]
  • Although there was no significant difference in the degree of overall disability at the peak of the illness, C. jejuni –positive patients took longer to recover and were more likely to be severely disabled at the end of one year.[nejm.org]
Splenectomy
  • He had HbE/beta zero thalassaemia and had undergone splenectomy nine months previously for hypersplenism; he also had chronic hepatitis C infection.[ncbi.nlm.nih.gov]
Nausea
  • You have diarrhea and are unable to drink fluids due to nausea or vomiting. You have a fever above 101 F (38.3 C), and diarrhea.[nlm.nih.gov]
  • The trickle soon grew to dozens, then hundreds, and ultimately thousands of residents suffering from debilitating cramps, headaches and nausea.[waterandhealth.org]
  • Jejuni infection in humans include acute, watery or bloody diarrhoea, stomach pain, fever, nausea and headaches. After a few weeks, the infection can even lead to serious auto-immune diseases, such as Guillain-Barré syndrome.[uu.nl]
  • Symptoms usually appear within 2 to 5 days after eating the contaminated food and include fever, stomach cramps, muscle pain, diarrhea, nausea and vomiting. Infection from C. jejuni may be treated with certain antibiotics.[babymed.com]
Abdominal Pain
  • Abstract Campylobacter jejuni infection frequently presents as acute enteritis with diarrhoea, malaise, fever and abdominal pain. Vomiting and bloody diarrhoea are reported less frequently.[ncbi.nlm.nih.gov]
  • Diarrhea accompanied by cramping, abdominal pain, and fever are the main symptoms. A number of complications may be seen with Campylobacter jejuni infection, one of them being Guillain-Barré syndrome.[symptoma.com]
  • Case report: We describe the case of a healthy two-year-old child with intermittent episodes of fever, abdominal pain, vomiting and soft stool since two months ago, with no relevant changes on physical examination.[revistas.rcaap.pt]
  • You have severe abdominal pain.[nlm.nih.gov]
Acute Diarrhea
  • Diagnosis and prevalence of enteropathogenic bacteria in children less than 5 years of age with acute diarrhea in Tehran children's hospitals. J Infect. 2009 Jan. 58(1):21-7. [Medline]. Wang SC, Chang LY, Hsueh PR, et al.[emedicine.medscape.com]
  • In Sweden, Campylobacter species is the most common pathogen reported in patients with acute diarrhea [ 1 ]. After an incubation period (usually of 2–4 days), the patient develops diarrhea, fever, malaise, and often abdominal cramps and pain.[dx.doi.org]
  • Evidence on the ability of L. acidophilus to treat acute diarrhea in children is mixed. Some studies have shown a beneficial effect, while others have shown no effect (14, 15).[healthline.com]
Heart Failure
  • INTRODUCTION: Infectious myocarditis is a life-threatening condition because it can lead to arrhythmia, dilated cardiomyopathy and congestive heart failure.[ncbi.nlm.nih.gov]
Anterior Uveitis
  • We report a case of acute anterior uveitis (AAU) in association with an outbreak of Campylobacter jejuni infection, with the first estimation of the incidence of AAU triggered by Campylobacter, and discuss reactive ophthalmological complications (AAU,[ncbi.nlm.nih.gov]
Guillain-Barré Syndrome
  • Abstract Guillain-Barré syndrome has been considered to be primarily an acute inflammatory demyelinating polyneuropathy (AIDP). Our experience with Guillain-Barré syndrome in northern China differs from the traditional concept.[ncbi.nlm.nih.gov]
Headache
  • The outbreak was recognized when blood cultures obtained from 11 previously healthy persons with acute febrile illnesses (characterized in over 80% by fever, diarrhea, and headaches) were positive for C. jejuni.[ncbi.nlm.nih.gov]
  • The trickle soon grew to dozens, then hundreds, and ultimately thousands of residents suffering from debilitating cramps, headaches and nausea.[waterandhealth.org]
  • […] dizziness, nausea, headaches, dry mouth, tiredness, and oliguria (infrequent urination) a constant feeling that you need to pass stool vomiting, which is rare Diarrhea can make you dehydrated.[healthline.com]
  • Jejuni infection in humans include acute, watery or bloody diarrhoea, stomach pain, fever, nausea and headaches. After a few weeks, the infection can even lead to serious auto-immune diseases, such as Guillain-Barré syndrome.[uu.nl]
  • Some complementary and alternative medicine (CAM) practitioners blame common symptoms such as fatigue, headache and poor memory on overgrowth of the fungus-like organism Candida albicans in the intestines, sometimes called "yeast syndrome."[mayoclinic.org]
Cranial Nerve Involvement
  • We report here a case of CIDP presenting as mononeuritis multiplex with accompanying cranial nerve involvement in an insulin-dependent diabetic who presented a preceding Campylobacter jejuni infection and misleading skin lesions.[ncbi.nlm.nih.gov]
  • Acute polyneuritis with cranial nerve involvement following Campylobacter jejuni infection. J Neurol Neurosurg Psychiatry 1985 ;48: 593 - 593 5. Enders U, Karch H, Toyka KV, et al.[nejm.org]
Neurologic Manifestation
  • Treatment with i.v. immunoglobulin (400 mg/kg/day x 5 days) led to rapid partial resolution of his neurologic manifestations, but complete recovery was not obtained until 6 months later.[ncbi.nlm.nih.gov]
Mononeuropathy
  • This case suggests that CIDP should be considered as a potential diagnosis in all diabetics with localized, acute or sub-acute onset, and multiple, or overlapping mononeuropathies.[ncbi.nlm.nih.gov]

Workup

Because acute gastroenteritis has a wide bacterial etiology with similar signs and symptoms, the physician's role in conducting a proper clinical workup is of importance. During history taking, patients should be asked about recent travel, consumption of "suspicious" animal products (particularly poultry, other meat products, and milk), while the course and progression of symptoms must be assessed as well. After a thorough physical examination, a complete laboratory workup is necessary, but apart from an increased white blood cell count, basic biochemical parameters are usually within physiological limits [1]. For this reason, microbiological studies are the focus of the diagnostic investigation. In all patients who present with signs of gastroenteritis, stool cultures are a vital component of the workup, including for Campylobacter jejuni infection [1] [2] [3]. Stool cultures require specific conditions (higher temperature and use of cephalothin), but because infected patients excrete bacteria in stools only for a few weeks [7], the use of more advanced methods is recommended. Identification of specific antibodies through serological methods possesses higher success rates compared to cultures, but the introduction of molecular methods and polymerase chain reaction (PCR), which are able to detect bacterial DNA in patient samples, have greatly improved the overall rate of diagnosis for many pathogens, including Campylobacter jejuni [2] [3] [7] .

Colitis
  • Ten patients had abnormal colonoscopic findings, including erythema (4), ulcers (4), colitis (1), and hemorrhage (1).[ncbi.nlm.nih.gov]
  • To Infectious colitis NOS Infectious enteritis NOS Infectious gastroenteritis NOS Type 1 Excludes colitis NOS ( K52.9 ) diarrhea NOS ( R19.7 ) enteritis NOS ( K52.9 ) gastroenteritis NOS ( K52.9 ) noninfective gastroenteritis and colitis, unspecified[icd10data.com]
  • […] or diarrhea begins) Reduced urine output, sunken eyes, sticky or dry mouth, or no tears when crying Food poisoning - campylobacter enteritis; Infectious diarrhea - campylobacter enteritis; Bacterial diarrhea; Campy; Gastroenteritis - campylobacter; Colitis[nlm.nih.gov]
  • Campylobacter colitis. Br Med J 1, 857 –859. [CrossRef] [Google Scholar] McCarthy, N. & Giesecke, J. ( 1999 ; ). Case–case comparisons to study causation of common infectious diseases. Int J Epidemiol 28, 764 –768.[jmm.microbiologyresearch.org]

Treatment

  • On the basis of these results, combined treatment with ciprofloxacin and maternal plasma was initiated, and the C. jejuni infection was rapidly cured.[ncbi.nlm.nih.gov]

Prognosis

  • The presence of Cj infection is more important than anti-GM1 positivity in determining the extent of axonal involvement and, hence, prognosis.[ncbi.nlm.nih.gov]
  • In addition, all patients were followed for one year to determine the effect of C. jejuni infection on prognosis.[nejm.org]
  • Prognosis Most otherwise healthy adults recover from Campylobacter infection within several days. Occasionally diarrhea may persist for up to 10 days. Complications other than dehydration are very uncommon.[drugs.com]
  • CMV reactivation in critically ill patients is known to worsen prognosis and increase mortality [ 26 - 28 ].[omicsonline.org]

Etiology

  • Because acute gastroenteritis has a wide bacterial etiology with similar signs and symptoms, the physician's role in conducting a proper clinical workup is of importance.[symptoma.com]
  • Smith T : The etiological relation of spirilla ( Vibrio fetus ) to bovine abortion. Journal of Experimental Medicine 1919, 30: 313–323. Google Scholar 3.[link.springer.com]
  • The NIH appears to accept the role of Campylobacter in GBS etiology and has moved to outlining steps for improving mechanistic knowledge (11); the published literature also reflects this general acceptance.[scienceblogs.com]
  • Key words Campylobacter, Argentina, prevalence, resistance, fluorquinolones, diarrhea, etiology Clasificación en siicsalud Artículos originales Expertos de Iberoamérica página www.siicsalud.com/des/expertocompleto.php/ Especialidades Principal: Infectología[siicsalud.com]
  • When antimicrobials are used to treat adults with enteritis, they are most effective in limiting the duration of illness when given early in the course of infection, before the etiologic agent is confirmed by culture [ 5 ].[doi.org]

Epidemiology

  • Sporadic accounts of case histories similar to the present have appeared in the literature, but the incidence and epidemiology of this infection in obstetric patients is still unclear.[ncbi.nlm.nih.gov]
  • Epidemiology of Campylobacter jejuni infections in the United States and other industrialized nations. In Campylobacter (2 ed., Vol. II/6, pp. 121-138). Washington, USA: ASM International.[orbit.dtu.dk]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology of Campylobacter enteritis. Microbiol Rev. 1986 Mar. 50(1):81-94. [Medline]. Wassenaar TM, Blaser MJ. Pathophysiology of Campylobacter jejuni infections of humans. Microbes Infect. 1999 Oct. 1(12):1023-33. [Medline].[emedicine.com]
  • Pathophysiology Factors responsible for the diseases caused by C jejuni are not well known.[emedicine.medscape.com]

Prevention

  • Author information 1 Department of Preventive Environment and Nutrition, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho 3-18-15, Tokushima City, Tokushima 770-8503, Japan.[ncbi.nlm.nih.gov]

References

Article

  1. Allos BM. Campylobacter jejuni Infections: update on emerging issues and trends. Clin Infect Dis. 2001;32(8):1201-1206.
  2. Nyati KK, Nyati R. Role of Campylobacter jejuni Infection in the Pathogenesis of Guillain-Barré Syndrome: An Update. Biomed Res Int. 2013;2013:852195.
  3. Kaakoush NO, Castaño-Rodríguez N, Mitchell HM, Man SM. Global Epidemiology of Campylobacter Infection. Clin Microbiol Rev. 2015;28(3):687-720.
  4. Coker AO, Isokpehi RD, Thomas BN, Amisu KO, Obi CL. Human Campylobacteriosis in Developing Countries1. Emerg Infect Dis. 2002;8(3):237-243.
  5. Friedman CR, Hoekstra RM, Samuel M, et al. Risk factors for sporadic Campylobacter infection in the United States: A case-control study in FoodNet sites. Clin Infect Dis. 2004;38(3):S285-296.
  6. Sarkar SR, Hossain MA, Paul SK, et al. Campylobacteriosis - an overview. Mymensingh Med J. 2014;23(1):173-180.
  7. Nachamkin I, Allos BM, Ho T. Campylobacter Species and Guillain-Barré Syndrome. Clin Microbiol Rev. 1998;11(3):555-567.

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Last updated: 2019-07-11 20:11