Infective Internal Iliac Artery Aneurysm Caused by Campylobacter fetus

A 67-year-old man with a persistent high fever was diagnosed to have an infective aneurysm in his left internal iliac artery. A blood culture detected a gram-negative spiral rod that was first identified as Campylobacter fetus subsp. venerealis based on a matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) analysis. However, the strain was finally confirmed to be Campylobacter fetus subsp. fetus based on a genetic analysis. The infection was successfully treated with emergency resection of the aneurysm, followed by 4 weeks of antibiotic therapy. Involvement of the peripheral artery is uncommon in cases of C. fetus-infective aneurysm. To figure out the epidemiology and pathogenicity of C. fetus infection, the accurate identification of the responsible organisms is essential.

Bilateral prosthetic knee infection by Campylobacter fetus

We present the first documented case of a bilateral prosthetic knee joint infection with Campylobacter fetus. Our patient's risk factors included age, the presence of prosthetic joints, and potential exposure through his contact with farm animals. It is important to be aware of the possibility of C fetus joint infections in high-risk patients who present with pain after total joint arthroplasty.

Campylobacter jejuni: unusual cause of cholecystitis with lithiasis. Case report and literature review

A 51-year-old man presented with acute cholecystitis and the routine intraoperative culture of the bile grew Campylobacter jejuni. The patient was cured by laparoscopic cholecystectomy without specific antimicrobial treatment. Cholecystitis owing to Campylobacter spp. could be missed because a culture for Campylobacter is not routinely requested nor is it cost effective to look for it in bile or gallbladder specimens. Moreover, the fastidious nature of these bacteria dictates against their recovery in routine culture. Because this is a rare infection at this site, a review of the literature on this infection is included.

Campylobacter jejuni-induced severe colitis--a rare cause of toxic megacolon

The development of toxic megacolon as a sequel of infectious colitis is rare. We have observed the very rare case of a campylobacter jejuni-induced toxic megacolon. A 28-year-old man was admitted with severe enterocolitis and appearance of blood in stools. He had been treated with loperamide without success. Two days after admission stool cultures revealed campylobacter jejuni and then an oral antibiotic therapy was started. On the fifth day clinical performance deteriorated again with development of toxic megacolon and consecutive subtotal colectomy. Rectoscopy before discharge after 13 days showed a normal mucosa. The unusual course with first improvement and then rapid deterioration despite adequate therapy was observed in 4 other cases, which may also be a hint of ensuing megacolon. Even in usually harmless enterocolitis like campylobacter infection, predisposing factors such as loperamide are known to precipitate toxic megacolon and should be considered in clinical practice.

Infected abdominal aortic aneurysm caused by Campylobacter fetus subspecies fetus: report of a case

A 45-year old man with fever, abdominal pain, and a pulsating mass underwent an aneurysmectomy, with in situ reconstruction using a bifurcated knitted Dacron graft, for a saccular abdominal aortic aneurysm (AAA). A culture taken postoperatively grew Campylobacter fetus subspecies fetus. The administration of antibiotics sensitive to this organism was continued for 3 months, and no infection has been encountered in the 1 year since his operation. This is only the 13th documented case of AAA infected by C. fetus subspecies fetus.

Infected subdural effusion associated with resolving subdural hematoma--case report

A 70-year-old male presented with rapid neurological deterioration and fever 3 months after suffering a closed head trauma. He underwent craniotomy for possible subdural empyema based on computed tomography and clinical findings. Dural incision revealed an outer membrane typical of chronic subdural hematoma which covered a clear, yellowish fluid containing Campylobacter fetus. Histological examination confirmed the capsule of the hematoma, with a necrotic focus infiltrated by neutrophils. Administration of intravenous imipenem and topical tobramycin and cefalothin achieved total resolution of his neurological deficits. Development of the infected subdural effusion was probably secondary to bacterial infection in the pre-existing chronic subdural hematoma in the resolving stage. The presence of the hematoma capsule always carries the risk of development of an infectious focus.

Acute cholecystitis caused by Campylobacter jejuni

An 83-year-old man with acute cholecystitis caused by Campylobacter jejuni is described. The patient was cured after undergoing cholecystectomy and intravenous ofloxacin therapy.

Campylobacter fetus endocarditis: two case reports and review

We report two cases of Campylobacter fetus endocarditis. The first case involved a bicuspid native aortic valve in a 60-year-old woman, and the second involved a prosthetic aortic valve in a 76-year-old woman. No source of infection was identified in either case. Despite antibiotic therapy, hemodynamic deterioration necessitated valve replacement; both patients recovered completely. C. fetus is an uncommon cause of human infection but may be responsible for severe illnesses such as endocarditis and thrombophlebitis because of its tendency to attack the vascular endothelium. Review of the literature revealed 21 cases of endocarditis caused by this organism, usually involving the aortic valve. To our knowledge, there are only two reported cases of prosthetic valve endocarditis. Our second patient is the oldest one encountered so far with this condition.

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.

Campylobacter jejuni infected bursitis

Campylobacter jejuni is a common cause of enteritis, and has been isolated from patients with bacteremia, meningitis, and cholecystitis. We describe here an unusual case of a chronically inflamed bursitis infected with C. jejuni.

Campylobacter fetus infection of abdominal aortic aneurysm

A 61-year-old man with Campylobacter fetus infection of an abdominal aortic aneurysm treated surgically is presented herein, the fifth survival case reported in the literature. Fever and back pain preceded the enlargement of atherosclerotic abdominal aortic aneurysm. The patient tolerated satisfactorily total excision of the aneurysm followed by axillo-femoral prosthetic bypass. Antibiotic therapy consisted of intravenous infusion of fosfomycin and gentamicin and oral administration of minocycline. The organism cultured from the aneurysmal wall and intraluminal thrombi was identified as Campylobacter fetus from its typical characteristics. It is concluded that this organism should be considered in all cases of infected aneurysm in elderly or debilitated patients.

Abdominal aortic aneurysm infected with Campylobacter fetus subspecies fetus

We report a survivor of Campylobacter fetus septicemia from an infected abdominal aortic aneurysm who was successfully treated with an anatomic graft reconstruction and antibiotics. According to a survey of the English-language medical literature this was the fourth such patient successfully treated. C. fetus sepsis associated with an abdominal aortic aneurysm was first reported in 1971. The first patient to survive reconstruction of an aortic tube graft aneurysm infected with C. fetus was reported in 1983. Because the natural history of an aneurysm infected by C. fetus appears to be rapid progression to rupture, patients should be operated on promptly. All patients reported in the literature who were operated on before rupture survived. Survival was independent of the type of reconstruction. When the aneurysm ruptured all patients died. Whereas extraanatomic bypass is generally considered the procedure of choice for an infected abdominal aneurysm, the aneurysms of our patient and three other patients cited in the literature were reconstructed with anatomically placed prosthetic grafts. In the absence of other contraindications such as a grossly evident purulent infection, an abdominal aortic aneurysm infected by C. fetus may represent a subset of infected aneurysms that can be treated successfully with an anatomically placed prosthetic graft and antibiotics.

Infected aortic aneurysms

Salmonella organisms have been responsible for half of the reported cases of infected aortic aneurysms, although other bacteria have been incriminated. This is the second reported case in which Campylobacter fetus subspecies fetus apparently infected an inflammatory aortic aneurysm. In this 70-year-old man the organism was isolated and treated prior to resection of the aneurysm and inline grafting. Specific antibiotic therapy was continued for 8 weeks postoperatively. Examination and CT scans obtained after 9 months of follow-up reveal no evidence of recurrent infection.