Campylobacter jejuni: Difference between revisions
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==Background== | ==Background== | ||
* Gram negative, non spore forming bacteria | * [[Gram negative]], non spore forming bacteria | ||
* Commonly found in animal feces | * Commonly found in animal feces | ||
* Caused by oral-fecal transmission | * Caused by oral-fecal transmission | ||
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==Clinical Features== | ==Clinical Features== | ||
* Acute diarrheal illness (<3 weeks) | * Acute diarrheal illness (<3 weeks) | ||
* Severe abdominal pain | * Severe [[abdominal pain]] | ||
* Fever | * [[Fever]] | ||
* Bloody/voluminous/purulent stools | * Bloody/voluminous/purulent stools | ||
* Systemic illness/symptoms | * Systemic illness/symptoms | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Infectious: | * Infectious: | ||
** Salmonella | ** [[Salmonella]] | ||
** Shigella | ** [[Shigella]] | ||
** Shiga toxin-producing E. coli | ** Shiga toxin-producing [[E. coli]] | ||
** E. coli 0157:H7 | ** [[E. coli]] 0157:H7 | ||
** Entamoeba histolytica | ** [[Entamoeba histolytica]] | ||
** Yersinia | ** [[Yersinia]] | ||
** Vibrio | ** [[Vibrio]] | ||
** C. difficile | ** [[C. difficile ]] | ||
* Non-infectious: | * Non-infectious: | ||
** Inflammatory bowel disease | ** [[Inflammatory bowel disease]] | ||
** GI bleed | ** [[GI bleed]] | ||
** Adrenal insufficiency | ** [[Adrenal insufficiency]] | ||
** Mesenteric ischemia | ** [[Mesenteric ischemia]] | ||
** Thyroid storm | ** [[Thyroid storm]] | ||
** Toxicologic exposure | ** [[Toxicologic exposure]] | ||
** Radiation syndrome | ** [[Radiation syndrome]] | ||
| Line 53: | Line 53: | ||
* Many recover without antimicrobial therapy | * Many recover without antimicrobial therapy | ||
* Antibiotics if severe illness: | * Antibiotics if severe illness: | ||
** Macrolides | ** [[Macrolides]] | ||
*** Azithromycin | *** [[Azithromycin]] | ||
** Fluroquinolones | ** [[Fluroquinolones]] | ||
*** Ciprofloxacin | *** [[Ciprofloxacin]] | ||
* Note- resistance is becoming prevalent | * Note- resistance is becoming prevalent | ||
Revision as of 15:40, 16 September 2015
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:
Diagnostic 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[1]
- 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
- Kman N. Disorders Presenting Primarily with Diarrhea. In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011: 531-536.