Campylobacter jejuni: Difference between revisions
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**[[Fluroquinolones]] | **[[Fluroquinolones]] | ||
***[[Ciprofloxacin]] | ***[[Ciprofloxacin]] | ||
*Note- resistance is becoming prevalent | *Note - resistance is becoming prevalent, especially ciprofloxacin, which is as high as 25% now<ref>CDC. Campylobacter (Campylobacteriosis) - Antibiotic resistance. Last modified October 2, 2017. https://www.cdc.gov/campylobacter/campy-antibiotic-resistance.html</ref> | ||
==Disposition== | ==Disposition== | ||
Revision as of 21:46, 24 September 2018
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 (non-typhi)
- 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
- Inflammatory bowel disease
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
- Giardia lamblia
- Cryptosporidiosis
- Entamoeba histolytica
- Cyclospora
- Clostridium perfringens
- Listeriosis
- Helminth infections
- Marine toxins
- Ciguatera
- Scombroid poisoning
- Paralytic shellfish poisoning
- Neurotoxic shellfish poisoning
- Diarrheal shellfish poisoning
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, especially ciprofloxacin, which is as high as 25% now[3]
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
- ↑ CDC. Campylobacter (Campylobacteriosis) - Antibiotic resistance. Last modified October 2, 2017. https://www.cdc.gov/campylobacter/campy-antibiotic-resistance.html