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.
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     . 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  . 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)    . 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  . 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)  . Up to 10 or more stools can be expected in typical cases, and the duration of symptoms is usually one week  , but a prolonged course of the disease with several-week-long complaints is reported in a subset of patients . 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   . 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   .
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 . 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   . Stool cultures require specific conditions (higher temperature and use of cephalothin), but because infected patients excrete bacteria in stools only for a few weeks , 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    .