Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Pediatric Campylobacter Infections Workup

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

Laboratory Studies

See the list below:

  • Microbiologic studies in Campylobacter infection
    • Presumptive diagnosis can be made by examination of fecal specimens by darkfield or phase-contrast microscopy, which demonstrates the characteristic darting motility, and a Gram stain of the stool, which shows Vibrio forms (slim, short, curved rods). RBCs and neutrophils are present in stool in approximately 75% of patients with Campylobacter enteritis.
    • Definitive diagnosis of infection is based on isolation of organisms from stool culture or from another site.
    • Culture of C jejuni from stool requires special isolation techniques and special media such as Campy-BAP or Skirrow. These media contain antibiotics that reduce the emergence of other enteric microorganisms. Inoculated media should be incubated in 5% oxygen and 10% carbon dioxide at 42°C. If C fetus or other atypical enteric species are suspected, isolation from stool requires inoculation on media lacking antibiotics and at 37°C. Filtration technique may be needed. Routine media are adequate for isolation of Campylobacter from normally sterile sites such as blood, body fluids, and tissues.
  • Hematology and blood chemistries
    • Peripheral WBC count is usually within the reference range; however, a left shift may occur.
    • The alanine aminotransferase level and the erythrocyte sedimentation rate (ESR) may be slightly elevated.
    • Other laboratory evaluations are within the reference ranges.
  • Serology
    • Diagnostic rise usually occurs after symptoms have resolved. Because the median duration of fecal excretion in the convalescent phase is less than 3 weeks, serology testing may be more sensitive than culture for the diagnosis of recent C jejuni infection.
    • Although serologic testing is also useful for epidemiologic investigations it is not recommended for routine diagnosis.
Next

Other Tests

See the list below:

  • DNA probes and polymerase chain reaction are mainly research tools at this time and are not routinely performed.[24]
Previous
Next

Procedures

See the list below:

  • In patients with Campylobacter colitis with history of acute onset of diarrhea, abdominal pain and rectal bleeding, sigmoidoscopy done early (within 5 d) during the illness revealed hyperemic rectal mucosa with occasional shallow aphthous ulcers, whereas findings of granularity and hyperemia were seen in patients whose sigmoidoscopy were done later (≥ 7 d) during the illness.[25]
Previous
Next

Histologic Findings

See the list below:

  • The spectrum of histologic findings in the intestinal tract ranges from minimal edema with acute and chronic inflammatory cells without vascular congestion, to moderate inflammation and cryptitis, to crypt abscess formation.
  • For perinatal infections secondary to C jejuni and C fetus, the placenta may have areas of necrosis, infarction, microabscesses, and inflammation.[19]
Previous
 
 
Contributor Information and Disclosures
Author

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.

Coauthor(s)

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.

References
  1. Zilbauer M, Dorrell N, Wren BW, Bajaj-Elliott M. Campylobacter jejuni-mediated disease pathogenesis: an update. Trans R Soc Trop Med Hyg. 2008 Feb. 102(2):123-9. [Medline].

  2. Allos BM. Campylobacter jejuni Infections: update on emerging issues and trends. Clin Infect Dis. 2001 Apr 15. 32(8):1201-6. [Medline].

  3. CDC. Vital signs: incidence and trends of infection with pathogens transmitted commonly through food--foodborne diseases active surveillance network, 10 U.S. sites, 1996-2010. MMWR Morb Mortal Wkly Rep. 2011 Jun 10. 60(22):749-55. [Medline].

  4. Foodborne Diseases Active Surveillance Network (FoodNet). Trends in Foodborne Illness in the United States, 1996–2011. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/foodnet/data/trends/trends-2011.html. Accessed: March 7, 2013.

  5. Feierl G, Jelovcan S. Campylobacteriosis in Austria: situation and trends. Wien Klin Wochenschr. 2009. 121(3-4):103-7. [Medline].

  6. Nichols GL, Richardson JF, Sheppard SK, Lane C, Sarran C. Campylobacter epidemiology: a descriptive study reviewing 1 million cases in England and Wales between 1989 and 2011. BMJ Open. 2012. 2(4):[Medline]. [Full Text].

  7. Jafari F, Garcia-Gil LJ, Salmanzadeh-Ahrabi S, Shokrzadeh L, Aslani MM, Pourhoseingholi MA. Diagnosis and prevalence of enteropathogenic bacteria in children less than 5 years of age with acute diarrhea in Tehran children's hospitals. J Infect. 2009 Jan. 58(1):21-7. [Medline].

  8. Wang SC, Chang LY, Hsueh PR, et al. Campylobacter enteritis in children in northern Taiwan--a 7-year experience. J Microbiol Immunol Infect. 2008. 41(5):408-413.

  9. Soofi SB, Habib MA, von Seidlein L, et al. A comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan. J Infect Public Health. 2011 Mar. 4(1):12-21. [Medline].

  10. Yang JR, Wu HS, Chiang CS, Mu JJ. Pediatric campylobacteriosis in northern Taiwan from 2003 to 2005. BMC Infect Dis. 2008. 8:151. [Medline].

  11. Gillespie IA, O'Brien SJ, Penman C, Tompkins D, Cowden J, Humphrey TJ. Demographic determinants for Campylobacter infection in England and Wales: implications for future epidemiological studies. Epidemiol Infect. 2008 Dec. 136(12):1717-25. [Medline].

  12. Samuel MC, Vugia DJ, Shallow S, et al. Epidemiology of sporadic Campylobacter infection in the United States and declining trend in incidence, FoodNet 1996-1999. Clin Infect Dis. 2004. 38 Suppl 3:S165-174.

  13. Coker AO, Isokpehi RD, Thomas BN, Amisu KO, Obi CL. Human campylobacteriosis in developing countries. Emerg Infect Dis. 2002 Mar. 8(3):237-44. [Medline].

  14. Sorokin M, Usein CR, Irimia M, Damian M. A laboratory-based survey of Campylobacter infections in Prahova County. Roum Arch Microbiol Immunol. 2007 Jul-Dec. 66(3-4):85-9. [Medline].

  15. Pacanowski J, Lalande V, Lacombe K, Boudraa C, Lesprit P, Legrand P. Campylobacter bacteremia: clinical features and factors associated with fatal outcome. Clin Infect Dis. 2008 Sep 15. 47(6):790-6. [Medline].

  16. Tee W, Mijch A. Campylobacter jejuni bacteremia in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients: comparison of clinical features and review. Clin Infect Dis. 1998 Jan. 26(1):91-6. [Medline].

  17. Blaser MJ. Extraintestinal Campylobacter infections. West J Med. 1986 Mar. 144(3):353-4. [Medline].

  18. Uzoigwe C. Campylobacter infections of the pericardium and myocardium. Clin Microbiol Infect. 2005 Apr. 11(4):253-5. [Medline].

  19. Fujihara N, Takakura S, Saito T, Iinuma Y, Ichiyama S. A case of perinatal sepsis by Campylobacter fetus subsp. fetus infection successfully treated with carbapenem--case report and literature review. J Infect. 2006. 53(5):e199-202.

  20. Simor AE, Karmali MA, Jadavji T, Roscoe M. Abortion and perinatal sepsis associated with campylobacter infection. Rev Infect Dis. 1986 May-Jun. 8(3):397-402. [Medline].

  21. Krishnaswamy R, Sasidharan P, Rejjal A, Osba YA. Early onset neonatal sepsis with Campylobacter jejuni: a case report. Eur J Pediatr. 1991 Feb. 150(4):277-8. [Medline].

  22. Zambrano LD, Levy K, Menezes NP, Freeman MC. Human diarrhea infections associated with domestic animal husbandry: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg. 2014 Jun. 108 (6):313-25. [Medline].

  23. Gazaigne L, Legrand P, Renaud B, Bourra B, Taillandier E, Brun-Buisson C. Campylobacter fetus bloodstream infection: risk factors and clinical features. Eur J Clin Microbiol Infect Dis. 2008 Mar. 27(3):185-9. [Medline].

  24. Bessede E, Delcamp A, Sifre E, et al. New methods for detection of campylobacters in stool samples in comparison to culture. J Clin Microbiol. 2011 Mar. 49(3):941-4. [Medline].

  25. Mee AS, Shield M, Burke M. Campylobacter colitis: differentiation from acute inflammatory bowel disease. J R Soc Med. 1985 Mar. 78(3):217-23. [Medline].

  26. Ternhag A, Asikainen T, Giesecke J, Ekdahl K. A meta-analysis on the effects of antibiotic treatment on duration of symptoms caused by infection with Campylobacter species. Clin Infect Dis. 2007 Mar 1. 44(5):696-700. [Medline].

  27. Alfredson DA, Korolik V. Antibiotic resistance and resistance mechanisms in Campylobacter jejuni and Campylobacter coli. FEMS Microbiol Lett. 2007 Dec. 277(2):123-32. [Medline].

  28. Valenza G, Frosch M, Abele-Horn M. Antimicrobial susceptibility of clinical Campylobacter isolates collected at a German university hospital during the period 2006-2008. Scand J Infect Dis. 2010. 42(1):57-60. [Medline].

  29. Ewnetu D, Mihret A. Prevalence and antimicrobial resistance of Campylobacter isolates from humans and chickens in Bahir Dar, Ethiopia. Foodborne Pathog Dis. 2010 Jun. 7(6):667-70. [Medline].

  30. Tremblay C, Gaudreau C. Antimicrobial susceptibility testing of 59 strains of Campylobacter fetus subsp. fetus. Antimicrob Agents Chemother. 1998 Jul. 42(7):1847-9. [Medline].

  31. Tremblay C, Gaudreau C, Lorange M. Epidemiology and antimicrobial susceptibilities of 111 Campylobacter fetus subsp. fetus strains isolated in Quebec, Canada, from 1983 to 2000. J Clin Microbiol. 2003 Jan. 41(1):463-6. [Medline].

  32. Huizinga R, van Rijs W, Bajramovic JJ, Kuijf ML, Laman JD, Samsom JN, et al. Sialylation of Campylobacter jejuni endotoxin promotes dendritic cell-mediated B cell responses through CD14-dependent production of IFN-β and TNF-α. J Immunol. 2013 Dec 1. 191 (11):5636-45. [Medline].

  33. Yuki N. Campylobacter sialyltransferase gene polymorphism directs clinical features of Guillain-Barré syndrome. J Neurochem. 2007 Nov. 103 Suppl 1:150-8. [Medline].

  34. McKhann GM, Cornblath DR, Griffin JW, Ho TW, Li CY, Jiang Z. Acute motor axonal neuropathy: a frequent cause of acute flaccid paralysis in China. Ann Neurol. 1993 Apr. 33(4):333-42. [Medline].

  35. Pope JE, Krizova A, Garg AX, Thiessen-Philbrook H, Ouimet JM. Campylobacter reactive arthritis: a systematic review. Semin Arthritis Rheum. 2007 Aug. 37(1):48-55. [Medline].

  36. Keithlin J, Sargeant J, Thomas MK, Fazil A. Systematic review and meta-analysis of the proportion of Campylobacter cases that develop chronic sequelae. BMC Public Health. 2014 Nov 22. 14:1203. [Medline].

  37. Peterson MC. Rheumatic manifestations of Campylobacter jejuni and C. fetus infections in adults. Scand J Rheumatol. 1994. 23(4):167-70. [Medline].

  38. Hannu T, Mattila L, Rautelin H, Pelkonen P, Lahdenne P, Siitonen A. Campylobacter-triggered reactive arthritis: a population-based study. Rheumatology (Oxford). 2002 Mar. 41(3):312-8. [Medline].

  39. Committee on Infectious Diseases, Committee on Nutrition, American Academy of Pediatrics. Consumption of raw or unpasteurized milk and milk products by pregnant women and children. Pediatrics. 2014 Jan. 133 (1):175-9. [Medline].

  40. Blaser MJ, Perez GP, Smith PF, Patton C, Tenover FC, Lastovica AJ. Extraintestinal Campylobacter jejuni and Campylobacter coli infections: host factors and strain characteristics. J Infect Dis. 1986 Mar. 153(3):552-9. [Medline].

  41. Braun KP, Theissig F, Ernst H, May M, Krulls-Munch J. [Campylobacter-jejuni-associated hepatitis and myocardial injury]. Med Klin (Munich). 2008 May 15. 103(5):346-8. [Medline].

  42. [Guideline] Diagnosis and management of foodborne illnesses: a primer for physicians and other health care professionals. MMWR Recomm Rep. 2004 Apr 16. 53:1-33. [Medline].

  43. Godschalk PC, Kuijf ML, Li J, St et al. Structural characterization of Campylobacter jejuni lipooligosaccharide outer cores associated with Guillain-Barre and Miller Fisher syndromes. Infect Immun. 2007. 75(3):1245-1254.

  44. Luquero Alcalde FJ, Sanchez Padilla E, Eiros Bouza JM, et al. [Trend and seasonal variations of Campylobacter gastroenteritis in Valladolid, Spain. A five-year series, 2000-2004]. Rev Esp Salud Publica. 2007. 81(3):319-326.

  45. Peterson MC. Clinical aspects of Campylobacter jejuni infections in adults. West J Med. 1994 Aug. 161(2):148-52. [Medline].

  46. Roan JN, Ko WC, Luo CY. Abdominal septic aortic pseudoaneurysm caused by Campylobacter jejuni infection: report of a case. Surg Today. 2009. 39(2):137-40. [Medline].

  47. Tokuda K, Nishi J, Miyanohara H, Sarantuya J, Iwashita M, Kamenosono A. Relapsing cellulitis associated with Campylobacter coli bacteremia in an agammaglobulinemic patient. Pediatr Infect Dis J. 2004 Jun. 23(6):577-9. [Medline].

Previous
Next
 
Scanning electron microscope image of Campylobacter jejuni, illustrating its corkscrew appearance and bipolar flagella. Source: Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.