Campylobacter jejuni Infections: Update on Presentation, Diagnosis, and Management

Hospital Physician July 2008 C ampylobacteriosis is a foodand water-borne zoonotic diarrheal illness caused by bacteria of the genus Campylobacter, with most cases caused by C. jejuni. Campylobacter species have a worldwide distribution, and campylobacteriosis is a leading cause of acute diarrhea and enterocolitis throughout the world. In the United States, approximately 1 million symptomatic Campylobacter infections occur each year.1 The majority of Campylobacter infections are acquired via the oral route after handling raw poultry or consuming undercooked poultry. Campylobacter species were first recognized in 1906 by John McFadyean, who described comma-shaped spiral organisms associated with abortions in cattle and sheep. Initially named Vibrio fetus, this pathogen was reclassified as Campylobacter fetus in 1973.2,3 Human disease was first described 1959, when organisms were isolated from the blood of children with acute dysentery.4 Campylobacter was first isolated from fecal specimens of patients with acute enteritis in 1972.5 These initial cases were followed by other sporadic cases worldwide, and community outbreaks due to contaminated water, unpasteurized milk, and community meals were identified.6–11 In 1978, a large community outbreak associated with the town water system affected 3000 people in Bennington, VT.8 Although campylobacteriosis is typically a self-limiting disease in otherwise healthy persons, severe gastrointestinal disease can occur in immunocompromised persons. In addition, postinfectious complications of Campylobacter infection, including Guillain-Barré syndrome and reactive arthritis, can occur in both immunocompromised and immunocompetent persons. This article provides an update on the presentation, diagnosis, and management of Campylobacter infection and its postinfectious complications.