infectious diseases
Campylobacter and Related Infections
Introduction
Campylobacterinfections typically cause self-limited diarrhea but occasionally cause bacteremia, with consequent endocarditis, osteomyelitis, or septic arthritis. Diagnosis is by culture, usually from stool. Treatment when needed includesazithromycin. Campylobacterspecies are motile, curved, microaerophilic, gram-negative bacilli that normally inhabit the gastrointestinal tract of many domestic animals and fowl. Several species are human pathogens. The major pathogens areC. jejuni,C. coli, andC. fetus. accounts for more cases of diarrhea in the US than Overview of Salmonella Infections and C. fetusand several otherCampylobacterspecies (eg,C. coliandC. lari) typically cause bacteremia and systemic manifestations in adults, more often when underlying predisposing diseases, such as diabetes, cirrhosis, cancer, or HIV/AIDS, are present.C. fetusis much less common thanC. jejuniand is usually an opportunistic pathogen affecting people with underlying disease, older people, and pregnant women. In pregnant patients, the rate of fetal loss can be as high as 70%.C. fetusinfections in healthy hosts occur in those with occupational exposure to infected animals. In patients with immunoglobulin deficiencies, these organisms, includingC. jejuni, may cause difficult-to-treat, relapsing infections. Hypochlorhydria and achlorhydria are predisposing factors becauseCampylobacterspecies are sensitive to gastric acid. The following have been implicated in outbreaks: Contact with infected animals (eg, puppies) Contact with contaminated food or water (eg, handling contaminated food) Ingestion of contaminated food (especially undercooked poultry), water, or unpasteurized raw milk Person-to-person transmission through fecal-oral and sexual contact may also occur but is uncommon because a large number ofCampylobacterorganisms are required to cause infection. Transmission ofCampylobacterinfectiondoesoccur among men who have sex with men. However, in sporadic cases, the source of the infecting organism is frequently obscure. 