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Pediatric Campylobacter Infections Clinical Presentation

  • Author: Jocelyn Y Ang, MD, FAAP, FIDSA; Chief Editor: Russell W Steele, MD  more...
Updated: Sep 30, 2015


Clinical manifestations of all Campylobacter species infections that cause enteric illness overlap and appear identical. These manifestations include the following:

Mild episodes of diarrhea subside within 7 days in 60-70% of cases, last for 2 weeks in 20-30%, and persist longer than 2 weeks in 5-10% of cases. In one third to one half of patients, initial symptoms include periumbilical cramping, intense abdominal pain that mimics appendicitis, malaise, myalgias, headache, and vomiting.

Watery secretory diarrhea consists of more than 10 stools per day and is frequently seen in younger children. Dehydration occurs in approximately 10% of these children.

Inflammatory diarrhea symptoms are indistinguishable from those caused by Shigella organisms, Escherichia coli, and Salmonella species. They are characterized by malaise, fever, abdominal cramps, tenesmus, bloody stools, and fecal leukocytes on light microscopy.

Rarely, in young adults and adolescents, inflammatory diarrhea can be severe and can be confused with Crohn disease and ulcerative colitis. Toxic megacolon with massive bleeding may occasionally occur. In asymptomatic neonates, C jejuni has been isolated from blood-streaked formed stools or hematochezia.

Bacteremia with C jejuni is uncommon and is most frequently found in patients with immunodeficiency,[16] patients with chronic illness,[15] and patients at extremes of ages. Bloodstream infections and systemic infections by C fetus are rare. The 3 patterns of bacteremia are as follows:

  • Transient bacteremia in a normal host with acute Campylobacter enteritis: These patients usually completely recover without treatment.
  • Secondary bacteremia or deep focus of infection such as meningitis, pneumonia, endocarditis, and thrombophlebitis in a normal host: Bacteremia usually originates from the intestinal tract and responds to antimicrobial therapy.
  • Chronic bacteremia with relapses that can persist for several months occurring in an immunocompromised host: In these patients, bacteremia can also arise from an infected indwelling catheter. Many such patients do not have acute enteritis.

Localized extraintestinal infections are uncommon manifestations and include cholecystitis, arthritis, urinary tract infection, pancreatitis, osteomyelitis, and meningitis.[17, 18] These manifestations may be the initial presentation of C jejuni infection or may occur simultaneously with bacteremia. They frequently are seen in patients who are immunocompromised or who are at extremes of age. Appropriate treatment is necessary.

Because of the affinity of C fetus for the genital tract (and by the tropism for fetal tissue), C fetus,[19, 20] and rarely C jejuni,[20, 21] are associated with perinatal infection. Abortion or stillbirth and premature labor have been described. Infants are often premature and develop signs and symptoms suggestive of sepsis, including fever, cough, respiratory distress, vomiting, diarrhea, cyanosis, convulsions, and jaundice. Infection typically progresses to meningitis, which may be rapidly fatal or may result in serious neurologic sequelae. The source of the organism in these cases has been the mother.



See the list below:

  • The abdomen is frequently tender upon palpation, especially the right lower quadrant.
  • Rarely, splenomegaly may be present.


See the list below:

  • Individuals at increased risk for Campylobacter enteritis include the following:
    • Those with occupational exposure to cattle, sheep, and other farm animals[22]
    • Laboratory workers
    • Those in contact with the excreta of infected persons
    • Homosexual men
  • The following underlying conditions increase risk for Campylobacter bacteremia, suggesting the importance of both humoral and cell-mediated immunity: [15, 16, 23]
Contributor Information and Disclosures

Jocelyn Y Ang, MD, FAAP, FIDSA Associate Professor, Department of Pediatrics, Wayne State University School of Medicine; Consulting Staff, Division of Infectious Diseases, Children's Hospital of Michigan

Jocelyn Y Ang, MD, FAAP, FIDSA is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.


Sharon Nachman, MD Professor of Pediatrics, Associate Dean for Research, Stony Brook University School of Medicine

Sharon Nachman, MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Mark R Schleiss, MD Minnesota American Legion and Auxiliary Heart Research Foundation Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Itzhak Brook, MD, MSc Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, Society for Ear, Nose and Throat Advances in Children, American Federation for Clinical Research, Surgical Infection Society, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

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Scanning electron microscope image of Campylobacter jejuni, illustrating its corkscrew appearance and bipolar flagella. Source: Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia.
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