Epidemiology of campylobacter diarrhoea

Severe Acute Cholangitis and Bacteremia Due to Campylobacter jejuni: A Case Report and Review of the Literature

Campylobacter jejuni is common cause of enteritis, but biliary infection rarely reported. An 82-year-old woman with pancreatic head cancer underwent endoscopic biliary drainage for malignant biliary obstruction. She was subsequently admitted for management of diarrhea. C. jejuni was identified in stool culture. Her symptoms resolved temporarily without antibiotics but flared up with a fever a few days later. She was diagnosed with acute cholangitis and bacteremia with C. jejuni. Endoscopic biliary drainage and antimicrobial administration improved her symptoms. As complications of C. jejuni diarrhea are rare, antibiotics are not necessarily indicated but sometimes are needed to prevent complications.

Campylobacter upsaliensis gastroenteritis in childhood

BACKGROUND

Campylobacter upsaliensis can cause gastroenteritis and bacteremia. Data on its epidemiology and role in pediatric gastroenteritis are limited.

OBJECTIVE

To describe the incidence and clinical features of enteric C. upsaliensis infection in children and to compare these with similar data for Campylobacter jejuni.

DESIGN AND METHODS

Medical records of all patients with enteric C. upsaliensis infection between 1992 and 1999 at the Royal Children's Hospital, Melbourne, were reviewed. A case-control study (age-matched 1:2) was performed to compare the severity of clinical disease and associated risk factors for infection with C. upsaliensis and C. jejuni.

RESULTS

Of 18,516 specimens 666 (3.6%) were positive for C. jejuni and 19 (0.1%) were positive for C. upsaliensis. Records were available for 18 patients with C. upsaliensis gastroenteritis (mean age, 1.6 years; median age, 1.3 years; range, 3 months to 7 years; 14 male). Eleven patients (61%) presented with acute and 7 (39%) with chronic or intermittent diarrhea. The case-control study showed that fever (P = 0.03), acute diarrhea (P = 0.05) and rectal bleeding (P = 0.0006) were significantly less common in C. upsaliensis than in C. jejuni infection.

CONCLUSION

C. upsaliensis is a rare cause of gastroenteritis in young children and, compared with C. jejuni infection, is associated with significantly lower rates of fever, acute diarrhea and rectal bleeding.

Bacteraemia caused by Campylobacter spp

The genus Campylobacter has become increasingly recognised as the cause of various infections. Campylobacter jejuni and C coli cause acute gastroenteritis in man all over the world. C jejuni enteritis can lead to bacteraemia, but its actual incidence remains unknown. Seven cases of bacteraemia caused by C jejuni or C coli are reported, from the blood of seven patients: five immune deficient adults; a newborn baby; and a patient who had had abdominal surgery. Patients who develop diarrhoea as a result of Campylobacter infection are at risk of bacteraemia thereafter.

Campylobacter jejuni enterocolitis causing peritonitis, ileitis and intestinal obstruction

Patients with Campylobacter enterocolitis may come to laparotomy due to the severity of abdominal symptoms and signs, although only two patients with intestinal inflammation have been described and in neither was the histopathology documented. A case of a 52-year-old male who had a typical diarrhoeal illness of Campylobacter enterocolitis diagnosed on stool culture is reported. Despite appropriate treatment he developed signs and symptoms consistent with small intestinal obstruction. Laparotomy revealed peritonitis and thickened distal ileum with transmural inflammatory changes on histopathology. These changes were shown to have completely resolved at a second laparotomy, required for persistent obstruction due to adhesions. Recurrent adhesions culminated in a third laparotomy. The clinical, operative and histopathological findings may be confused with Crohn's disease.

Chicken carcasses as a source of Campylobacter jejuni in Belo Horizonte, Brazil

The presence of Campylobacter jejuni was investigated in stool specimens from chicken meat workers and in ready-for-market chicken carcasses from one industrial and nine non industrial slaughters in Belo Horizonte. In the latter C. jejuni was isolated from 19 (38.0%) of the 50 chicken carcasses and from 2 (13.3%) of the stool specimens obtained from 15 chicken meat workers. In the industrial slaughter it was found in only 1 (2.0%) of the 50 chicken carcasses and it was not isolated from any of the 40 stool specimens. There was a significant difference between industrial and non industrial slaughter in regard to the frequency of C. jejuni isolation from carcasses (p = 0.000002), probably due to the low hygiene conditions present in non industrial slaughters. The results of antimicrobial susceptibility tests, SDS gel electrophoresis and biotyping of the strains isolated from stool specimens obtained from chicken meat workers were similar to those observed in strains isolated from chicken carcasses which suggest that chicken could be the source of C. jejuni for the workers and both, chicken and workers, could be implicated in the transmission of C. jejuni infection in Belo Horizonte.

Peritonitis caused by Campylobacter jejuni and serologically confirmed in a patient being treated with continuous ambulatory peritoneal dialysis

A case of Campylobacter jejuni peritonitis in a patient being treated with continuous ambulatory peritoneal dialysis is described. The significance of the organism isolated from our patient was initially doubtful because of a rapid defervescence of symptoms with minimal specific antibiotic therapy, lack of a preceding diarrhoeal illness and the time taken to isolate and identify the organism. Serial serum IgM, IgA and IgG antibody estimations clearly showed an acute seroconversion confirming that the strain of C. jejuni isolated was the causative organism in this case.

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.

Campylobacter jejuni/Campylobacter coli-associated Guillain-Barré syndrome. Immunoblot confirmation of the serological response

Immunoblot (Western blot) examination of the sera of 45 patients with the Guillain-Barré syndrome demonstrated that between three and five immunoreactive bands that were characteristic of a recent Campylobacter jejuni/Campylobacter coli infection were present in 22 of these patients. The immunoblots paralleled the serological response that is found in campylobacter enteritis and confirmed the specificity of our previous enzyme-linked immunosorbent assays (ELISAs), which indicates that antecedent C. jejuni/C. coli infection is common in patients with the Guillain-Barré syndrome. We postulate that, under certain circumstances, demyelination is initiated by the leakage of campylobacter-specific antibody across the blood-nerve barrier.