Campylobacter jejuni
๐ Campylobacter infection is a zoonotic cause of bacterial gastroenteritis, often linked to undercooked poultry, meat, or contaminated milk.
It is one of the commonest causes of bacterial diarrhoea worldwide and can lead to serious complications such as Guillain-Barrรฉ syndrome.
๐ About
- Zoonotic infection causing acute bacterial diarrhoea.
- Common sources: undercooked chicken, meat, contaminated milk, and occasionally untreated water.
- Complications: Guillain-Barrรฉ syndrome (autoimmune neuropathy), Reactive arthritis, and bacteraemia in immunocompromised patients.
๐งฌ Characteristics
- Gram-negative curved bacillus โ classic โseagull wingsโ appearance under the microscope.
- Motile via a single polar flagellum ๐.
- Capsulated, nonโspore-forming.
- Optimal growth at 42ยฐC under microaerophilic conditions (5โ10% Oโ, 10% COโ).
๐ Types
- Campylobacter jejuni โ most common cause in humans.
- Campylobacter coli โ also causes diarrhoea but less common.
- Campylobacter fetus โ tends to affect immunocompromised patients, often causing systemic infection.
๐ฆ Aetiology & Pathogenesis
- Virulence factors: lipopolysaccharide endotoxin, cytotoxins, and ability to invade the intestinal mucosa.
- Reservoir: wild birds, poultry, domestic animals ๐๐๐.
- Transmission: ingestion of undercooked poultry, unpasteurised milk, contaminated water, or cross-contamination in kitchens.
๐ค Clinical Features
- Incubation: 2โ5 days after ingestion.
- Typical illness: acute colitis with colicky abdominal pain, fever, malaise, diarrhoea often with blood and pus.
- Severe cases: dehydration, septicaemia (esp. immunocompromised).
- Post-infectious complications:
- Guillain-Barrรฉ syndrome (autoimmune demyelinating neuropathy).
- Reactive arthritis (HLA-B27 association).
๐งช Investigations
- Stool culture โ grows on selective charcoal agar at 42ยฐC under microaerophilic conditions.
- Characteristic grey colonies.
- Oxidase + and Catalase +.
- Blood cultures in suspected bacteraemia.
๐ Management
- ๐ Supportive therapy: Oral/IV rehydration, electrolyte replacement.
- Most cases are self-limiting within 2โ5 days.
- Antibiotics reserved for:
- Severe or prolonged disease
- Immunocompromised patients
- Extra-intestinal complications
- First-line: Macrolides (e.g. Erythromycin, Azithromycin).
- Alternative: Fluoroquinolones (e.g. Ciprofloxacin) โ but resistance is increasingly common โ.
๐ Key Notes for Exams & Practice
- Think Campylobacter in a patient with bloody diarrhoea after chicken consumption.
- Complication to always mention: Guillain-Barrรฉ syndrome.
- Differentiate from Salmonella/Shigella by history + stool culture.