Campylobacter infections. Differential diagnosis of enterocolitis.

Question 1

what are the PATHOGENS FOR CAMPYLOBACTERIOSIS ?

Answer 1

campylobacter jejuni - most common

campylobacter coli
= diarrhoea disease

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c fetus - extra intestinal infection(bacteraemia) most in elderly

Question 2

what are the CHARACHTERISTICS OF CAMPYLOBACTER JEJUNI ?

Answer 2

curved
gram negative
oxidase positive
polar flagella

GROWS best at hot temperatures = 37-42 degrees

highly contagious - low infective dose - 500 pathogens

Question 3

what is the TRANSMISSION IN CAMPYLOBACTER ENTERITIS ?

Answer 3

Campylobacter infections are zoonotic, with a variety of
animals serving as reservoirs - chicken and other poultry, wild birds, pigs, dogs, cats, sheep, and cow

fecal oral

contaminated water and food (undercooked food)

direct contact with infected animals and animal products

Question 4

what is the PATHOGENESIS OF CAMPYLOBACTER ? /////

Answer 4

organisms are killed when
exposed to gastric acids,
so conditions that decrease
or neutralize gastric acid secretion favor disease

C. jejuni
produces histologic damage to the
mucosal surfaces of
the jejunum (as implied by the name of the species),
ileum, and colon. The mucosal surface appears ulcerated,
edematous, and bloody, with crypt abscesses in the epithelial gland

Question 5

what is the INCUBATION PERIOD FOR CAMPYLOBACTER ENTERITIS?

Answer 5

2-4 days

Question 6

what are the CLINICAL FEATURES OF CAMPYLOBACTERIOSIS ?

Answer 6

upto a week

high fever

dizziness

watery diarrhea and
inflammatory bloody diarrhea - esp in children

severe abdominal pain may present as pseudoappendicitis or colitis

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c fetus - systemic illness like fever,
chills,
seeding on organ like brain, bone

Question 7

what are the COMPLICATIONS OF CAMPYLOBACTERIOSIS ?

Answer 7

most common immunocompromised patients

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GUILLAIN-BARRE SYNDROME - autoimmune disorder of
the peripheral nervous system
characterized by development
of symmetric weakness

ASSOCIATED WITH SPECIFIC SEROTYPES (PRIMARILY C. JEJUNI SEROTYPE O:19). pathogenesis of this disease is related to ANTIGENIC
CROSS-REACTIVITY BETWEEN
the surface lipopolysaccharides of some strains of Campylobacter and peripheral nerve gangliosides

Ascending paralysis
Bilateral flaccid paralysis
Spreads from the lower to the upper limbs in a

Landry paralysis: involvement of the respiratory muscles → respiratory failure

Muscle reflexes:
Reduced or absent
Commonly beginning in the lower limbs

Neuropathic pain:

Autonomic dysfunction :
Arrhythmia
Blood pressure dysregulation: ↑ or ↓
Voiding dysfunction
Intestinal dysfunction

Cranial nerve involvement:
Facial diplegia due to frequent bilateral facial nerve involvement
Also affects glossopharyngeal nerve (IX) and vagal nerve (X)

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reactive arthritis

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acute abdomen - cholecystitis and pancreatitis

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septicemia.

Question 8

what is the diagnosis of campylobacteriosis ?

Answer 8

Microscopy of stool specimen
-characteristic appearance as a comma- or spiral-shaped gram-negative bacillus.

stool culture
campylobacter agar

stool - Antigen detection (immunoassay) in stool

stool - PCR

Question 9

what is the TREATMENT OF CAMPYLOBACTERIOSIS ?

Answer 9

Typically self-limiting

only in severe cases - macrolides - erythromycin /azithromycin