Campylobacter Infections Clinical Presentation

Updated: Jun 16, 2017
  • Author: Mahmud H Javid, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Presentation

History

Campylobacter infections can range from asymptomatic to severe life-threatening colitis with toxic megacolon.

All Campylobacter species associated with enteric illnesses cause identical clinical manifestations.

Gastroenteritis

The symptoms and severity of the gastroenteritis produced can vary.

Patients may have a history of ingestion of inadequately cooked poultry, unpasteurized milk, or untreated water. The incubation period is 1-7 days and is probably related to the dose of organisms ingested.

A brief prodrome of fever, headache, and myalgias lasting up to 24 hours is followed by crampy abdominal pain, fever as high as 40°C, and as many as 10 watery, frequently bloody, bowel movements per day. Fever, which develops in more than 90% of patients, may be low or high grade and can persist for a week.

Patients with C jejuni infection who report vomiting, bloody diarrhea, or both tend to have a longer illness and require hospital admission. [7]

Abdominal pain and tenderness may be localized. Pain in the right lower quadrant may mimic acute appendicitis (pseudoappendicitis).

Tenesmus occurs in approximately 25% of patients.

In some cases, acute abdominal pain is the only symptom, with pain typically in the right lower quadrant. Among the symptoms, abdominal pain is more likely to result from Campylobacter infection than from Salmonella or Shigella infections.

Differences based on Campylobacter species 

In contrast to C jejuni infection, C fetus infection causes diarrheal illness less frequently and is the most commonly identified species in bacteremia. However, C fetus infection that produces diarrheal illness results in clinical manifestations that are similar to those of C jejuni infection. C fetus is an opportunistic agent in debilitated hosts, but healthy hosts may also be affected.

Campylobacter bacteremia is common, and C fetus fetus is frequently isolated from the bloodstream, possibly because it resists the bactericidal activity of serum, while the more common C jejuni does not. Persons who develop Campylobacter bacteremia are usually older and are more likely to have cellulitis, endovascular infection, or a device-related infection. [8]

Systemic illness with a predilection for vascular sites is characteristic. Meningitis, vascular infections, and abscesses may be present.

C fetus infection may cause intermittent diarrhea or nonspecific abdominal pain.

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Physical

Patients with Campylobacter infection may appear to be ill.

The patient’s abdomen is diffusely tender, frequently in the right or left lower quadrant.

Among symptoms, only abdominal pain is more likely to result from Campylobacter infections than from Salmonella and Shigella infections.

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Causes

Campylobacter organisms are curved or spiral, motile, non–spore-forming, gram-negative rods. Organisms from young cultures have a vibriolike appearance, but, after 48 hours of incubation, organisms appear coccoid. Campylobacter organisms are motile by means of unipolar or bipolar flagellae. They are both oxidase- and catalase-positive and microaerophilic, requiring reduced oxygen (5-10%) and increased carbon dioxide (3-10%). The organisms grow slowly, with 3-4 days required for primary isolation from stool samples, and even longer from blood.

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