Please explain the cause, treatment and consequences of a bacterial infection due to Campylobacter.

Johnny

Campylobacter is a genus of bacteria with about 15 species, two of which commonly cause human infection. Most of these infections result in diarrhea. Campylobacter jejuni, the most common species to infect humans, is found in most animals that we consume. While most laypeople consider salmonella to be the main risk of eating poorly cooked chicken, in fact, it is estimated that 60 percent of consumer chicken in the United States is contaminated with Campylobacter. Milk and beef can also be sources of Campylobacter, but this usually occurs only if there is a mistake in the handling of the products. There can also be outbreaks of disease from contaminated water, though fortunately this happens only rarely.

Within three to seven days of consuming the organisms, people often begin to have abdominal pain and diarrhea. Some people first have a few days of nausea and fever, and others do not actually develop diarrhea at all. Campylobacter infection cannot be reliably diagnosed based on signs and symptoms, though the combination of fever, abdominal pain and diarrhea is suggestive. The diarrhea usually only lasts for four or five days, but there are many cases where it can persist for more than two weeks. The abdominal pain and general ill feeling may last for quite a while.

There are some unusual manifestations of Campylobacter infection. "Pseudoappendicitis" occurs when there is significant Campylobacter infection where the small and large intestines meet, causing pain that mimics appendicitis. Sometimes, if there is prominent infection of the large intestine, the symptoms may mimic the inflammatory disorder ulcerative colitis.

Serious complications are not very common. They include bacterial infection of the bloodstream, liver, pancreas and gallbladder; massive bleeding because of intestinal perforation; and the hemolytic uremic syndrome, a serious blood disorder more commonly seen with infection due to the bacterium E. coli. In addition, arthritis can occur weeks after infection with Campylobacter. Finally, Campylobacter infection is the most common identifiable cause of the Guillain-Barre syndrome, a neurologic disorder that causes paralysis, usually starting in the legs and moving upward. There can even be paralysis of the respiratory muscles, such that the patient must be placed on a ventilator. Fortunately, while Guillain-Barre syndrome is frequently the result of Campylobacter infection, the vast majority of Campylobacter infections do not lead to neurologic problems.

The diagnosis of Campylobacter diarrhea usually requires that a medical laboratory attempt to culture (grow microorganisms from) a stool sample. It takes a few days for the culture to become positive, so the patient is often already recovering before the definitive diagnosis is made.

In some cases, patients do not need treatment with antibiotics. Patients who are quite ill, on the other hand, may need treatment even before the results of the stool culture are known. The usual antibiotic for Campylobacter infection is erythromycin (trade name E-mycin), but ciprofloxacin (Cipro) and related antibiotics are often used, because these antibiotics can treat other cases of infectious diarrhea, while erythromycin is only effective against Campylobacter.