Medicine & USMLE

Campylobacter jejuni

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Bacteria - Gram Negative
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Campylobacter jejuni 

  • Characteristics
    • Gram negative corkscrew-shaped rod
      • First test in algorithm, narrows scope of bacteria
      • Possesses filaments with a corkscrew-appearance
    • Oxidase +
      • All gram negative curved rods are oxidase positive 
    • Grows at 42ºC
      • Specific to Campylobacter jejuni 
  • Transmission
    • Fecal-oral (contaminated food/water)
      • ingestion of undercooked poultry or meat, unpasteurized milk
    • Contact with infected animals (cows, dogs, sheep, chickens) is also a risk factor
  • Presentation
    • Major cause of bloody diarrhea, especially in children
      • Most common cause of bacterial diarrhea in the US
      • Initially begins as watery diarrhea, and then progresses to bloody diarrhea
      • Invasion of GI mucosa by bacteria leads to inflammation and bleeding
      • May also present with abdominal cramps
    • Often complicated by
      • Guillain-Barre syndrome
        • Acute polyneuropathy with ascending muscle weakness
        • Loss of deep tendon reflexes
        • Paralysis of respiratory muscles may be fatal
      • Reactive arthritis
        • Unilateral arthritis of the large joints (e.g. knee).
        • Associated with conjunctivitis and urethritis
  • Diagnosis 
    • Stool culture
      • gold standard for diagnosis
  • Treatment
    • Supportive care (intravenous hydration and electrolyte repletion) for all patients
    • Macrolides (erythromycin/azithromycin) for severe infections