Case study:
41 year old man presented with 4 month history of worsening abdominal pain, diarrhoea, nausea and vomiting with blood. His pain was mostly in the upper right quadrant. The main had recently immigrated to Australia from Kenya. Physical examination revealed enlarged spleen and liver with mild tenderness. What are the differential diagnoses? Why?
Differential diagnosis:
- Schistosomiasis should be considered as it is endemic in the area the patient has come from.
- Typhoid fever should be considered in patients with fever and abdominal pain who have recently been on a tropical/developing country.
- Acute viral hepatitis should be considered with patients with fever and right upper quadrant pain, although haematemesis would not be expected
Campylobacter characteristics of bacteria
- Small, curved motile
* Gram negative rods.
Campylobacter transmission
- Via faecal-oral route (contaminated food e.g. poultry, direct contact with faecal material)
- Infective dose: 100 bacteria
Campylobacter infection symptoms
- C. jejuni infection typically results in abdominal pain, fever and diarrhoea which may be mucopurulent or bloody.
- Symptoms usually last 2-5 days
Campylobacter virulence factors
- LPS
- Flagella
- Cytotoxins
- Hemolysins
- Secreted protease HtrA
- Phospholipase A
Treatment for campylobacter infections
Mild cases - fluid replacement only
Severe cases - erythromycin or clarithromycin
Diagnosis of Campylobacter
Special media (e.g. Skirrows supplement - inhibits growth of floral microorganisms)
