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| | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Name = Campylobacter | | | Name = Campylobacter | |
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| OMIM = | | | OMIM = | |
| MedlinePlus = 000224 | | | MedlinePlus = 000224 | |
| eMedicineSubj = ped | | | eMedicineSubj = | |
| eMedicineTopic = 2697 | | | eMedicineTopic = | |
| eMedicine_mult = {{eMedicine2|med|263}} | | | eMedicine_mult = | |
| MeshName = Campylobacter | | | MeshName = Campylobacter | |
| MeshNumber = B03.440.180 | | | MeshNumber = B03.440.180 | |
| }} | | }} |
| {{SI}} | | {{Campylobacteriosis}} |
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| | {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} |
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| ==Overview== | | ==[[Campylobacteriosis overview|Overview]]== |
| '''Campylobacteriosis''' is among the most common [[List of infectious diseases|bacterial infections]] of [[human]]s. It produces an inflammatory, sometimes bloody, [[diarrhea]] or [[dysentery]] syndrome. It is responsible for proctocolitis in participants of anoreceptive intercourse, bacteremia in AIDS patients and other immunocompromised patients, and [[travelers' diarrhea]]. ''[[Helicobacter pylori]]'' is closely related to ''[[Campylobacter]]'' and causes peptic ulcer disease.
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| ==Epidemiology== | | ==[[Campylobacteriosis historical perspective|Historical Perspective]]== |
| An estimated 2 million cases of ''[[Campylobacter]]'' [[enteritis]] occur annually in the [[United States|U.S.]], accounting for 5-7% of cases of [[gastroenteritis]]. A large animal reservoir is present, with up to 100% of poultry, including [[chicken]]s, [[turkey]]s, and waterfowl, having asymptomatic infections in their intestinal tracts. An infected [[chicken]] may contain up to 10<sup>9</sup> bacteria per 25 grams, and due to the installations, the bacteria is rapidly spread to other [[chicken]]. Ten to five hundred bacteria are enough to infect humans.
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| ==Pathophysiology== | | ==[[Campylobacteriosis pathophysiology|Pathophysiology]]== |
| ''Campylobacter'' organisms are curved or spiral, motile, non–spore-forming, [[gram-negative]] rods. The known routes of transmission are fecal-oral, person-to-person sexual contact, raw [[milk]] and [[poultry]] ingestion, and waterborne (ie, through contaminated water supplies). Exposure to sick pets, especially puppies, has also been associated with outbreaks. The infectious dose is 1000-10,000 bacteria. ''Campylobacter'' species are sensitive to [[hydrochloric acid]] in the [[stomach]], and acid reduction treatment can reduce the amount of inoculum needed to cause disease. Symptoms begin after an incubation period of one to seven days. The sites of tissue injury include the [[jejunum]], the [[ileum]], and the [[Colon (anatomy)|colon]]. ''C jejuni'' appears to invade and destroy epithelial cells. Some strains of ''C jejuni'' produce a [[cholera]]-like enterotoxin, which is important in the watery diarrhea observed in infections. The organism produces diffuse, bloody, edematous, and exudative enteritis. In a small number of cases, the infection may be associated with [[hemolytic uremic syndrome]] and [[thrombotic thrombocytopenic purpura]] through a poorly understood mechanism. In patients with [[HIV]], infections may be more frequent, may cause prolonged or recurrent diarrhea, and may be more commonly associated with bacteremia and antibiotic resistance. The severity and persistence of infection in patients with AIDS and [[hypogammaglobulinemia]] indicates that both cell-mediated and humoral immunity are important in preventing and terminating infection.
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| ==Features== | | ==[[Campylobacteriosis causes|Causes]]== |
| Patients usually have a history of ingestion of inadequately cooked or contaminated meat (poultry in particular), unpasteurized milk, or untreated water. The actual [[latent period]] is 1-6 days (typically 1-2 days) . A brief prodrome of fever, headache, and myalgias lasting as long as 24 hours is followed by crampy abdominal pain, fever as high as 40°C, and as many as 10 watery, frequently bloody, bowel movements per day. Abdominal pain and tenderness may be very localized, mimicking acute appendicitis. Complications include toxic megacolon, dehydration and sepsis. Generalized form of the infection can occur in little children ( < 1 year of age) and immunocompromised people. Chronic course of the disease is possible; such form of the process is likely to develop without a distinct acute phase. Chronic campylobacteriosis features long period of sub-[[febrile]] temperature, [[asthenia]] and depletion; eye damage, [[arthritis]], [[endocarditis]] may develop if infection is untreated.
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| | ==[[Campylobacteriosis differential diagnosis|Differentiating Campylobacteriosis from other Diseases]]== |
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| | ==[[Campylobacteriosis epidemiology and demographics|Epidemiology and Demographics]]== |
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| | ==[[Campylobacteriosis risk factors|Risk Factors]]== |
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| | ==[[Campylobacteriosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| ''Campylobacter'' organisms can be detected on gram stain of stool with high specificity and a sensitivity of ~60%, but are most often diagnosed by stool culture. Fecal [[leukocytes]] are present and indicate an inflammatory diarrhea.
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| | [[Campylobacteriosis history and symptoms|History and Symptoms]] | [[Campylobacteriosis physical examination|Physical Examination]] | [[Campylobacteriosis laboratory findings|Laboratory Findings]] | [[Campylobacteriosis other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| In most cases, reposition of liquid and electrolytes is enough.
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| The use of antibiotics is controversial. Some studies show that [[erythromycin]] rapidly eliminates ''Campylobacter'' from the stool without affecting the duration of illness. Studies in children with dysentery due to C jejuni have shown benefit from early treatment with erythromycin. Treatment with antibiotics, therefore, depends on the severity of symptoms. Antimotility agents, such as [[loperamide]], can lead to prolonged illness or intestinal perforation in any invasive diarrhea, and should be avoided.
| | [[Campylobacteriosis medical therapy|Medical Therapy]] [[Campylobacteriosis primary prevention|Primary Prevention]] | [[Campylobacteriosis secondary prevention|Secondary Prevention]] | [[Campylobacteriosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Campylobacteriosis future or investigational therapies|Future or Investigational Therapies]] |
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| ==Prognosis== | | ==Case Studies== |
| It is usually self-limited without any mortality. Occasional deaths occur in young, previously healthy individuals because of volume depletion and in persons who are elderly or immunocompromised.
| | [[Campylobacteriosis case study one|Case #1]] |
| ==Prevention==
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| *Pasteurization of milk and chlorination of drinking water destroy the organism.
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| *Treatment with antibiotics can reduce fecal excretion.
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| *Infected health care workers should not provide direct patient care
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| *Separate cutting boards should be used for foods of animal origin and other foods. After preparing raw food of animal origin, all cutting boards and countertops should be carefully cleaned with soap and hot water.
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| ==See also== | | ==Related Chapters== |
| * [[Campylobacter]] | | * [[Campylobacter]] |
| * [[enteritis]] | | * [[enteritis]] |
| * [[gastroenteritis]] | | * [[gastroenteritis]] |
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| | | [[Category:Disease]] |
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| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Bacterial diseases]] | | [[Category:Bacterial diseases]] |
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| [[bs:Kampilobakterioza]] | | [[bs:Kampilobakterioza]] |