Campylobacter infection is one of the leading causes of acute diarrhoea worldwide and is the most commonly reported bacterial cause of acute gastroenteritis in developed countries. It is also a major cause of traveller's diarrhoea.
Campylobacter jejuni is the primary cause of acute enteritis, causing 80% to 90% of all cases of recognised illness due to Campylobacter infection. Campylobacter coli is the second most common cause of acute enteritis. Campylobacter fetus is a rare cause of extra-intestinal infection, mainly in immunocompromised people.
Campylobacters are carried by a wide variety of wild and domestic animals, most commonly birds. Most C jejuni infections in humans come from the consumption of infected poultry.
Diarrhoea is usually self-limited and resolves in 5-7 days. Campylobacter bacteraemia is very rare.
Fluid and electrolyte replacement is essential. Only a small proportion of patients benefit from antimicrobial therapy.
C jejuni infection is a commonly identified antecedent to Guillain-Barre syndrome. C fetus is associated with endovascular problems (e.g., mycotic aneurysm, septic thrombophlebitis).
Bacteria of the genus Campylobacter cause a variety of infections, most commonly acute diarrhoeal illnesses. In patients with liver disease, immunocompromised people, and older people, Campylobacter infection can cause bacteraemia or extraintestinal infection. There are many species of Campylobacter. Eleven of them cause human illness, including enteric and extra-intestinal disease. The major human pathogens are C jejuni and C coli, which usually cause acute enteritis, and C fetus, which is the major pathogen causing extra-intestinal illnesses.
History and exam
Key diagnostic factors
- presence of risk factors
- abdominal pain
Other diagnostic factors
- prodrome of headache, myalgias, chills, fever
- recent foreign travel
- eating raw or undercooked meat (especially chicken)
- exposure to poultry, cattle, sheep, or other farm animals
- HIV infection
- male sex
- drinking untreated water
- drinking unpasteurised milk
- close contact with infected person
- use of proton pump inhibitors or H2 antagonists, especially in older patients
1st investigations to order
- stool microscopy
- stool culture
- white blood cell count
Investigations to consider
- serum Campylobacter serology
- intestinal biopsy
- faecal microscopy
- stool Gram stain
- Salmonella gastroenteritis
- Shigella gastroenteritis
- Yersinia gastroenteritis
- Campylobacter: guidance, data and analysis
- 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea
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