Campylobacter infection
Campylobacter is a comma-shaped, gram-negative bacillus and a leading cause of bacterial bloody diarrhea from undercooked poultry, unpasteurized milk, or infected animal contact, usually self-limited but treated with azithromycin for severe or high-risk disease, and a recognized trigger of Guillain-Barre syndrome and reactive arthritis.
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What this article covers
- Overview
A gram-negative, microaerophilic, comma- or S-shaped bacillus that grows optimally at 42 degrees C, distinguishing it in culture from most other enteric pathogens.
- Epidemiology
Acquired through consumption of inadequately cooked poultry, contaminated meat, food, or water, or unpasteurized milk, and through fecal-oral transmission from infected pets or animals (dogs, cats, pigs).
- Risk factors
Consumption of undercooked poultry or contaminated meat, the leading source of infection.
- Pathophysiology
Ingested organisms colonize and invade the small and large intestinal mucosa, producing an inflammatory colitis that accounts for the crampy abdominal pain and, frequently, grossly bloody stool.
- Clinical features
Diarrhea, typically watery but visibly bloody in about 15% of patients, is the presenting symptom, following the roughly 3-day incubation period.
- Differential diagnosis
Salmonella gastroenteritis: also causes fever and bloody diarrhea from contaminated poultry/eggs, but is a leading enteric fever/dysentery cause distinguished by stool culture speciation rather than…
- Diagnosis
Campylobacter infection is confirmed by a positive routine stool culture or a rapid multiplex molecular (nucleic acid amplification) gastrointestinal panel of the stool, which identifies the organism…
- Management
First, determine whether the patient needs any antibiotic at all: most Campylobacter diarrhea resolves spontaneously without antibiotics, so supportive care (oral rehydration, antipyretics) alone is…
- Complications
Guillain-Barre syndrome: the most serious well-recognized complication, developing 1 to 3 weeks after the diarrheal illness in a proportion of patients, with ascending symmetric weakness, dysautonomia, and risk of respiratory failure.
- Prognosis
Diarrhea caused by Campylobacter usually resolves spontaneously, even without antibiotic therapy, in the majority of healthy patients.
- Prevention
Cook poultry and other meats thoroughly before consumption to eliminate the organism.
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