Iron deficiency anemia in an athlete associated with Campylobacter pylori-negative chronic gastritis

A 14-year-old athletic boy with a 1-year history of decreased exercise tolerance presented with unexplained iron deficiency anemia. Panendoscopy, colonoscopy, and barium contrast studies of the gastrointestinal tract were normal. However, persistent uptake of radionuclide using a 99mtechnetium-sucralfate scan suggested inflammation localized to the stomach. Mucosal biopsies demonstrated acute and chronic gastritis that was not associated with the presence of Campylobacter pylori.

Campylobacter pylori associated acute gastritis in a child

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Gastroenteritis associated with Campylobacter cinaedi

The atypical Campylobacter spp. are being associated increasingly with gastroenteritis in certain population groups. We report the clinical and laboratory features of four cases (in three homosexual men and one heterosexual man) of gastroenteritis that was associated with Campylobacter cinaedi. The infection that was caused by this organism clinically was indistinguishable from other mild gut infections and resolved spontaneously without treatment. Faecal microscopy was unhelpful in the diagnosis. Successful culture of C. cinaedi required incubation of the specimen at 37 degrees C under microaerophilic conditions on cephalothin-free media--a procedure that usually is not undertaken in culturing for the more-common faecal pathogens. C. cinaedi needs to be considered in the investigation of the cause of diarrhoea in population groups such as homosexual men.

Infectoepidemilogic and immunologic implications of Campylobacter coli enteritis in one newborn monozygotic twin pair

Since campylobacter infections in humans at early age have not been thoroughly documented yet, it seemed interesting to report the occurrence of two simultaneous cases of C. coli enteritis in one newborn monozygotic twin pair. Their clinical history, epidemiology and microbiological analysis, development of specific serum and mucosal immunity as well as total Ig synthesis are discussed on the basis of their close genetic and environmental relationships.

Fecal alpha-1-antitrypsin excretion in acute diarrhea: relationship with causative pathogens

Concentrations of alpha-1-antitrypsin (AT) in random fecal samples from 68 infants (92.7% outpatients) with acute diarrhea and 32 healthy controls were determined. The mean +/- s.d. for AT in infants with diarrhea was 2.07 +/- 1.88 mg/g dry stool (mg/g d.s.) compared with 1.29 +/- 0.72 mg/g d.s. (p less than 0.05) in controls. Fecal AT was significantly greater than that of the controls only for diarrhea caused by Rotavirus or Salmonella. Salmonella patients also had significantly higher fecal levels of AT than patients with diarrhea caused by Campylobacter. Fifty percent of the infants with Salmonella infections excreted more than 2.73 mg/g d.s. AT, which is above the control mean + 2 s.d. Fecal excretion of AT was highest in patients with macroscopic intestinal bleeding, but it still depended more on the causative agent than on bleeding per se. This finding of increased intestinal protein loss during acute diarrhea, even in the less severe diseases, emphasizes the necessity to rapidly restart adequate nutritional intake.

Treatment of Campylobacter pylori gastritis: a pilot study using pirenzepine dihydrochloride (Gastrozepin) and three formulations of colloidal bismuth subcitrate (De-Nol)

Antral biopsies were obtained to detect Campylobacter pylori infection in 382 patients referred for gastroscopy. One hundred and seventy four patients (46%) were infected. Infection was strongly associated with histological gastritis (p less than 0.001), but there was no association between histological antral gastritis and the appearance of the gastric antrum during gastroscopy. Because it has been suggested that the lower relapse rate for duodenal ulcer following colloidal bismuth subcitrate (CBS) is due to suppression of C pylori we investigated different formulations and dosing of CBS for their efficacy in clearing C pylori. Seventy four infected patients were prospectively assigned to therapy with pirenzepine (11 patients) or one of four regimens of CBS; one swallow tablet 4 times a day (11 patients); two swallow tablets twice daily (16 patients); two buffered swallow tablets twice daily (14 patients); or two chew tablets twice daily (22 patients). All patients treated with pirenzepine and one CBS swallow tablet 4 times a day were still infected after treatment. Infection was not detected in 16 patients taking twice daily doses of CBS; 8 (50%), 3 (21%) and 5 (23%) patients taking two standard, buffered or chew tabs twice daily respectively. Improvement of histological gastritis was observed only in those patients apparently cleared of C pylori (p less than 0.01) and this was due to a decrease in polymorphonuclear leukocytes. Nine patients apparently cleared of the infection were rebiopsied 44-137 days following treatment and 6 (66%) were found again to be infected. This study suggests that suppression of C pylori may vary with the formulation and dosing of CBS.(ABSTRACT TRUNCATED AT 250 WORDS)

Campylobacter

Campylobacter is now known to be a major cause of gastrointestinal illness throughout the world. There are seven species known to be associated with enteritis, and it is likely that more will be described. Campylobacter jejuni is responsible for more than 95 per cent of the cases of diarrhea due to Campylobacter. Contaminated food products are the major source of infection. The clinical illness usually involves diarrhea, abdominal pain, and other constitutional symptoms. An accurate diagnosis of Campylobacter enteritis is made when the organism is cultured from the patient's stool. Selective media are widely available, and the isolation of C. jejuni is not difficult. Although erythromycin and the quinolones have good in vitro activity against C. jejuni, antibiotic therapy generally is not indicated.

Bacteria in ulcer pathogenesis

A great deal of information about the spiral bacteria of the stomach has accumulated in the past 5 years. These bacteria, currently named Campylobacter pylori but likely to be renamed as a new genus, have adapted to living beneath the mucus layer and above the gastric surface mucous cells. When metaplastic gastric mucous cells are also present in the duodenal bulb, C. pylori may also get a foothold in this latter location. Observations of the high prevalence of C. pylori in patients with gastritis and with duodenal ulcers, and the slightly lower prevalence in patients with gastric ulcer, have led to the hypothesis that the bacteria play an aetiological role in these three conditions. There is now fairly convincing evidence that the organisms can cause active chronic gastritis. The most persuasive of this comes from reports of the rapid development of gastritis and symptoms in two volunteers who swallowed the organism, plus two other series of accidental challenges. Other evidence is provided by the waning and waxing of gastritis, which has been correlated in several studies with clearance followed by recrudescence of the organisms. The role of the bacterium in peptic ulcer is less certain. The present data do not provide strong evidence for a causal role in gastric ulcer, although we cannot rule out that it may be important in some. The very high prevalence in patients with duodenal ulcer, including one series in children (who rarely harbour the organism), raises the distinct possibility that the bacteria play an aetiological role in this form of ulcer. Reports of ulcer healing with antibiotics and of lower recurrence rates in those cleared of the organism, increase the possibility, However, methodological flaws in some studies, plus the usual need for confirmation of key studies, indicate that we should await more definitive evidence before accepting that duodenal ulcer can be an infectious disease.

Campylobacter fetus endocarditis on a prosthetic heart valve

Campylobacter fetus infection in man is rare. Few cases of Campylobacter endocarditis have been described, and none have been associated with a prosthetic heart valve. We have reported a case of Campylobacter fetus ssp fetus on a prosthetic mitral valve in a 48-year-old woman who was treated successfully with penicillin and streptomycin (and later with gentamicin). Replacement of the prosthetic valve was done because of stenosis and vegetations. Pathologic examination showed vegetations on a calcified prosthesis, but no bacteria were seen.