Campylobacter

Definition | Aetiology | Pathophysiology | Risk Factors | Signs and Symptoms | Investigations | Management

Definition

Campylobacter infection is a bacterial cause of gastroenteritis, commonly presenting with diarrhoea, abdominal pain, and fever. It is one of the leading causes of foodborne illness worldwide.

Aetiology

  • Caused by Campylobacter jejuni and Campylobacter coli.
  • Transmission occurs via ingestion of contaminated food (particularly undercooked poultry), unpasteurised milk, or contaminated water.
  • Person to person transmission is rare but possible via faecal-oral route.

Pathophysiology

  • Bacteria invade the intestinal mucosa, leading to inflammation and ulceration.
  • Produces cytotoxins that contribute to diarrhoea and systemic symptoms.
  • Can trigger post infectious complications such as Guillain-Barré syndrome.

Risk Factors

  • Consumption of undercooked or contaminated poultry.
  • Exposure to farm animals or contaminated water sources.
  • Travel to endemic areas.
  • Immunocompromised individuals (HIV, chemotherapy).
  • Use of proton pump inhibitors (PPIs), which increase susceptibility.

Signs and Symptoms

  • Watery or bloody diarrhoea.
  • Severe abdominal cramping (often mimicking appendicitis).
  • Fever, malaise, and myalgia.
  • Nausea and vomiting (less common).
  • Complications: Guillain-Barré syndrome, reactive arthritis, bacteraemia in immunocompromised patients.

Investigations

  • Stool culture: confirms Campylobacter infection.
  • Stool microscopy: may show motile, curved Gram-negative rods.
  • Polymerase chain reaction (PCR): rapid detection of bacterial DNA.
  • Full blood count (FBC): may show leukocytosis.
  • Renal function and electrolytes: assess for dehydration.

Management

1. Supportive Care:

  • Oral rehydration therapy for mild cases.
  • IV fluids in severe dehydration.
  • Avoid antimotility agents (e.g., loperamide) to prevent prolonged infection.

2. Antibiotic Therapy (For Severe or Prolonged Cases):

  • First line: azithromycin.
  • Alternative: ciprofloxacin (in cases without resistance concerns).
  • Antibiotics generally not required for mild, self-limiting cases.

3. Prevention:

  • Proper cooking of poultry and food hygiene.
  • Avoid unpasteurised milk and untreated water.
  • Handwashing after handling raw meat.

4. Referral:

  • Infectious diseases: for persistent or severe cases.
  • Neurology: if Guillain Barré syndrome develops.
  • Gastroenterology: for post infectious complications.
Infectious DiseasemypanotesCampylobacter