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Campylobacter jejuni
From WikEM
Contents
Background
- Gram negative, non spore forming bacteria
- Commonly found in animal feces
- Caused by oral-fecal transmission
- Associated with Guillain-Barre syndrome and Reiter syndrome
Clinical Features
- Acute diarrheal illness (<3 weeks)
- Severe abdominal pain
- Fever
- Bloody/voluminous/purulent stools
- Systemic illness/symptoms
Differential Diagnosis
- Infectious:
- Salmonella
- Shigella
- Shiga toxin-producing E. coli
- E. coli 0157:H7
- Entamoeba histolytica
- Yersinia
- Vibrio
- C. difficile
- Non-infectious:
Acute diarrhea
Infectious
- Viral (e.g. rotavirus)
- Bacterial
- Campylobacter
- Shigella
- Salmonella (nontyphi)
- Escherichia coli
- E. coli 0157:H7
- Yersinia enterocolitica
- Vibrio cholerae
- Clostridium difficile
- Parasitic
- Toxin
Noninfectious
- GI Bleed
- Appendicitis
- Mesenteric Ischemia
- Diverticulitis
- Adrenal Crisis
- Thyroid Storm
- Toxicologic exposures
- Antibiotic or drug-associated
Watery Diarrhea
- Enterotoxigenic E. coli (most common cause of watery diarrhea)[1]
- Norovirus (often has prominent vomiting)
- Campylobacter
- Non-typhoidal Salmonella
- Enteroaggregative E. coli (EAEC)
- Enterotoxigenic Bacteroides fragilis
Traveler's Diarrhea
Evaluation
- Initiate work up in patients:
- Appearing toxic
- Febrile
- Diarrheal illness lasting >3 days
- Blood or pus in stool
- Immunocompromised patients with presumed infectious diarrhea
- Bacterial stool culture
- Stool ova and parasites if concern for parasitic infection
- Consider C. difficile PCR if patient has risk factors
- Note- in many labs, stool culture tests for Salmonella, Shigella, and Campylobacter; discuss with your lab for further testing
- Note- not every patient with fever and diarrhea needs work up, use clinical judgment
Management[2]
- Fluid resuscitation- oral rehydration therapy preferred
- Avoid antimotility agents with bloody diarrhea
- Many recover without antimicrobial therapy
- Antibiotics if severe illness:
- Note- resistance is becoming prevalent
Disposition
- Home for most patients
- Admit for rehydration in those with severe illness/inability to tolerate PO
See Also
External Links
References
- ↑ Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.
- ↑ http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/#treat
