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Overview

 


Campylobacter bacteria, usually transmitted in contaminated food or water, can infect the gastrointestinal tract and cause diarrhea, fever, and cramps. Good hand-washing and food safety habits will help prevent Campylobacter infections (or campylobacteriosis), which usually clear up on their own but sometimes are treated with antibiotics.

Campylobacter infects over 2 million people each year, and it's a leading cause of diarrhea and food-borne illness. Babies under 1 year old, teens, and young adults are most commonly affected.


Causes


Campylobacter is found in the intestines of many wild and domestic animals. The bacteria are passed in their feces, which can lead to infection in humans via contaminated food, meats (especially chicken), water taken from contaminated sources (streams or rivers near where animals graze), and milk products that haven't been pasteurized.

Bacteria can be transmitted from person to person when someone comes into contact with fecal matter from an infected person, especially a child in diapers. Household pets can carry and transmit the bacteria to their owners.


Symptoms


Symptoms usually appear 1 to 7 days after ingestion of the bacteria. The main symptoms of campylobacteriosis are fever, abdominal cramps, and mild to severe diarrhea. Diarrhea can lead to dehydration, which should be closely monitored. Signs of dehydration include: thirst, irritability, restlessness, lethargy, sunken eyes, dry mouth and tongue, dry skin, fewer trips to the bathroom to urinate, and (in infants) a dry diaper for several hours.

In cases of campylobacteriosis, the diarrhea is initially watery, but later may contain blood and mucus. Sometimes, the abdominal pain appears to be a more significant symptom than the diarrhea. When this happens, the infection may be mistaken for appendicitis or a problem with the pancreas.


Prevention


You can prevent campylobacteriosis by using drinking water that's been tested and approved for purity, especially in developing countries, and by drinking milk that's been pasteurized. While hiking and camping, avoid drinking water from streams and from sources that pass through land where animals graze. Kill any bacteria in meats by cooking these foods thoroughly and eating while still warm. Whenever you prepare foods, wash your hands well before and after touching raw meats, especially poultry. Clean cutting boards, countertops, and utensils with soap and hot water after contact with raw meat.

As you care for a family member who has diarrhea, remember to wash your hands before touching other people in your household and before handling foods. Clean and disinfect toilets after they're used by the person with diarrhea. Also, if a pet dog or cat has diarrhea, wash your hands frequently and check with your veterinarian about treatment.


Diagnosis


Your doctor may send a stool sample to the lab to be tested for Campylobacter bacteria. Other lab tests may also be needed, especially if your child has blood in the stool.


Treatment


Campylobacter infections causing gastroenteritis in uncomplicated cases are usually self-limiting; they resolve without treatment, as is the case with other organisms, such as salmonella. The most appropriate treatment is fluid and electrolyte replacement. In serious cases intravenous solutions of fluid and electrolytes may be required. With less serious volume depletion oral rehydration using glucose and electrolyte solutions may be indicated.

Antibiotic treatment has its place with certain groups of patients - those presenting with high fever, bloody diarrhoea and more than eight stools a day, patients whose symptoms have not lessened or are worsening, or those who have had symptoms persisting for more than a week. The antibiotic of choice in these cases is erythromycin, with ciprofloxacin a useful alternative.

Using erythromycin in cases of Campylobacter infection has been shown to eliminate carriage within 72 hours in most patients, unlike infections with salmonella, where use of antibiotics in uncomplicated cases may prolong the period of carriage.

Patients with immunodeficiency are particularly at risk from severe complications of Campylobacter infections. Fatal cases of C. jejuni septicaemia in patients with AIDS have been reported, where a clinical picture of fulminant septic shock despite therapy has been seen (Manfredi et al, 1999). Campylobacter are important opportunist pathogens in HIV disease, causing septicaemic illness.




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