Campylobacter jejuni

Background

Microbiology

• Curved Gram-negative bacillus
• Grows best at 42ºC (body temperature of birds)
• Exhibits darting motility

Epidemiology

• Major host is birds, including poultry

Clinical Manifestations

• Causes infectious diarrhea, including dysentery

Diagnosis

• Stool culture or PCR

Management

• Supportive care for the diarrhea
• Antibiotic choice depends on where the infection was acquired
  • Ciprofloxacin 500 mg PO bid for 3 days is useful where there are relatively low rates of resistance (North American and Europe)
    • Or other fluoroquinolone for 3 days
  • Azithromycin 500 mg PO daily for 3 days is useful where there are higher rates of resistance (especially South and Southeast Asia)
  • An alternative is rifaximin 200 mg PO tid for 3 days, but should be avoided in patients who have dysentery or fever
• Resistant to most first- through third-generation cephalosporins, but still susceptible to carbapenems

Prognosis

• Usually a self-limited illness whose duration is shortened by antibiotics
• Can subsequently develop post-infectious irritable bowel syndrome
• Most common cause of Guillain-Barré syndrome