Campylobacter jejuni

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Background

Clinical Features

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

Differential Diagnosis

Acute diarrhea

Infectious

Noninfectious

Watery Diarrhea

Traveler's Diarrhea

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[2]

  • 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

External Links

References

  1. Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.
  2. http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/#treat