Difference between revisions of "Campylobacter jejuni"

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==Background==
 
==Background==
* Gram negative, non spore forming bacteria
+
* [[Gram negative]], non spore forming bacteria
 
* Commonly found in animal feces
 
* Commonly found in animal feces
 
* Caused by oral-fecal transmission
 
* Caused by oral-fecal transmission
Line 7: Line 7:
 
==Clinical Features==
 
==Clinical Features==
 
* Acute diarrheal illness (<3 weeks)
 
* Acute diarrheal illness (<3 weeks)
* Severe abdominal pain
+
* Severe [[abdominal pain]]
* Fever
+
* [[Fever]]
 
* Bloody/voluminous/purulent stools  
 
* Bloody/voluminous/purulent stools  
 
* Systemic illness/symptoms
 
* Systemic illness/symptoms
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==Differential Diagnosis==
 
==Differential Diagnosis==
 
* Infectious:
 
* Infectious:
** Salmonella
+
** [[Salmonella]]
** Shigella
+
** [[Shigella]]
** Shiga toxin-producing E. coli
+
** Shiga toxin-producing [[E. coli]]
** E. coli 0157:H7
+
** [[E. coli]] 0157:H7
** Entamoeba histolytica  
+
** [[Entamoeba histolytica]]
** Yersinia
+
** [[Yersinia]]
** Vibrio
+
** [[Vibrio]]
** C. difficile  
+
** [[C. difficile ]]
 
* Non-infectious:
 
* Non-infectious:
** Inflammatory bowel disease  
+
** [[Inflammatory bowel disease]]
** GI bleed
+
** [[GI bleed]]
** Adrenal insufficiency
+
** [[Adrenal insufficiency]]
** Mesenteric ischemia  
+
** [[Mesenteric ischemia]]
** Thyroid storm
+
** [[Thyroid storm]]
** Toxicologic exposure  
+
** [[Toxicologic exposure]]
** Radiation syndrome
+
** [[Radiation syndrome]]
  
  
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* Many recover without antimicrobial therapy
 
* Many recover without antimicrobial therapy
 
* Antibiotics if severe illness:
 
* Antibiotics if severe illness:
** Macrolides
+
** [[Macrolides]]
*** Azithromycin
+
*** [[Azithromycin]]
** Fluroquinolones
+
** [[Fluroquinolones]]
*** Ciprofloxacin
+
*** [[Ciprofloxacin]]
 
* Note- resistance is becoming prevalent
 
* Note- resistance is becoming prevalent
  

Revision as of 15:40, 16 September 2015

Background

Clinical Features

  • Acute diarrheal illness (<3 weeks)
  • Severe abdominal pain
  • Fever
  • Bloody/voluminous/purulent stools
  • Systemic illness/symptoms


Differential Diagnosis


Diagnostic Evaluation

  • Initiate work up in patients:
    • Appearing toxic
    • Febrile
    • Diarrheal illness lasting >3 days
    • Blood or pus in stool
    • Immunocompromised patients with presumed infectious diarrhea
  • Bacterial stool culture
  • Stool ova and parasites if concern for parasitic infection
  • Consider C. difficile PCR if patient has risk factors
  • Note- in many labs, stool culture tests for Salmonella, Shigella, and Campylobacter; discuss with your lab for further testing
  • Note- not every patient with fever and diarrhea needs work up, use clinical judgment


Management[1]

  • Fluid resuscitation- oral rehydration therapy preferred
  • Avoid antimotility agents with bloody diarrhea
  • Many recover without antimicrobial therapy
  • Antibiotics if severe illness:
  • Note- resistance is becoming prevalent

Disposition

  • Home for most patients
  • Admit for rehydration in those with severe illness/inability to tolerate PO

See Also

Diarrhea

External Links

References

  • Kman N. Disorders Presenting Primarily with Diarrhea. In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011: 531-536.