Overview
Campylobacter is a genus of found in the gastrointestinal tract. Campylobacter jejuni is a Gram-negative rod that resembles small, tightly coiled spirals and is the most common cause of infectious gastroenteritis in the UK. It is spread by the faecal-oral route, has an incubation period of 1-6 days and invades the jejunum and ileum.
Infection is associated with consuming contaminated food and drink, such as undercooked food, unpasteurised milk, and untreated water.
Presentation
Overview
Around 1/4 of people may be asymptomatic. Features can include:
- A prodrome of fever along with headaches, and malaise
- Diarrhoea which is often bloody – seen in ~40% of people
- Abdominal cramping and pain – may be severe and mimic appendicitis
Management
Overview
Infection is usually self-limiting, however treatment is indicated if symptoms are severe (high fever, bloody diarrhoea, or >8 stools/day) or symptoms have lasted >1 week:
- 1st-line: clarithromycin – an alternative is ciprofloxacin, however, resistance has been noted
Complications
Overview
- Guillain-Barré syndrome (GBS) – Campylobacter can lead to GBS after 1-2 weeks and may be seen in up to 1/3 of GBS cases. This occurs due to molecular mimicry where antigens on Campylobacter are similar to gangliosides in nerves, resulting in an immune response.
- Reactive arthritis – characterised by features remembered with ‘can’t see, pee, or climb a tree’ (conjunctivitis, urethritis, and arthritis).
- Sepsis, myocarditis, and arthritis are also associated with Campylobacter
Prognosis
- Most cases are self-limiting within 2-3 days and resolve within 1 week
