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Section 3. Summaries of Infectious Diseases

Campylobacter Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

Predominant symptoms of Campylobacter infections include diarrhea, abdominal pain, malaise, and fever. Stools can contain visible or occult blood. In neonates and young infants, bloody diarrhea without fever can be the only manifestation of infection. Abdominal pain can mimic that produced by appendicitis or intussusception. Mild infection lasts 1 or 2 days and resembles viral gastroenteritis. Most patients recover in less than 1 week, but 20% have a relapse or a prolonged or severe illness. Severe or persistent infection can mimic acute inflammatory bowel disease. Bacteremia is uncommon but can occur in children, including neonates. Immunocompromised hosts can have prolonged, relapsing, or extraintestinal infections, especially with Campylobacter fetus and other species. Immunoreactive complications, such as acute idiopathic polyneuritis (Guillain-Barré syndrome), Miller Fisher syndrome (ophthalmoplegia, areflexia, ataxia), reactive arthritis, Reiter syndrome (arthritis, urethritis, and bilateral conjunctivitis), and erythema nodosum, can occur during convalescence.


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ETIOLOGY

Campylobacter species are motile, comma-shaped, gram-negative bacilli that cause gastroenteritis. Campylobacter jejuni and Campylobacter coli are the most common species isolated from patients with diarrhea. C fetus predominantly causes systemic illness in neonates and debilitated hosts. Other Campylobacter species, including Campylobacter upsaliensis, Campylobacter lari, and Campylobacter hyointestinalis, can cause similar diarrheal or systemic illnesses in children.


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EPIDEMIOLOGY

An estimated 2.4 million cases of Campylobacter infection occur in the United States each year, leading to 13 000 hospitalizations and 124 deaths. Data from the Foodborne Diseases Active Surveillance Network (www.cdc.gov/foodnet) indicate a 30% decrease in the incidence of infections since 1996. In 2007, the incidence was 12.8 per 100 000 population. The highest rates of infection . . . [Go to Full Text]


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