Campylobacter Jejuni, a bacteria.
Campylobacter are gram-negative, motile rods meaning, that
or move on the culture plate and they are characteristic in
their seagull-shape with a single flagellum.
In fact, if you can remember one thing about Campylobacter,
it is that they appear like the seagull wings on staining.
They have very fastidious growth requirements as well
and in fact, require elevated temperatures, 42 degrees
Celsius in a carbon dioxide enriched environment.
So, to isolate Campylobacter as we’ll talk about in just a
one requires a specific culture plate and a specific culture
In addition Campylobacter are both oxidase and catalase
How do the Campylobacter cause their disease?
First and foremost like many other infections in the gut,
the Campylobacter Jejuni must invade the mucosal surfaces
throughout the intestine.
When embedded in the mucosal surfaces, they’re able to
create and produce toxins, endo, entero,
and cytotoxins, pretty much a full smorgasbord of toxins
being produced into the gut and affecting other gut lining
Now, the body of course is very anti-Campylobacter and does
whatever it can to remove that bacteria
as well as many others which are not supposed to normally be
in the intestine.
And so, the immune response to Campylobacter includes
complement cascade as well as development of antibodies.
And so, we’ll see in just a little bit, this immunologic
cascade has downstream effects
and sometimes allowing autoimmune type diseases to occur.
However, gastric juices when present are also a wonderful
way to get rid of Campylobacter
but hypersecretion of gastric juices of course,
can allow for additional damage including erosive lesions to
the intestines downstream.
Finally, the antibody mediated killing which the immune
the humoral immune system would precipitate against any
foreign invader many times creates a cross-linked reaction
to parts of the Campylobacter cell wall which develops
to other parts of the human neurologic system and
As I just mentioned, these then can create an auto-immune
allowing further disease to occur, not just gastrointestinal
But the major problem from Campylobacter is indeed that.
Acute gastroenteritis, typically transmitted through
Yes, that’s poop to mouth and it does happen and it many
times happens with person to person contact as well.
As a brief reminder, washing your hands, good idea
especially after going to the toilet.
Ingesting undercooked poultry as well as undercooked meats
and unpasteurized milk
are other frequent sources of Campylobacter
and in fact, one can sometimes see point source outbreaks in
associated with contamination of their water supply with
Also, contact with infected animals especially sharing
kisses, those lovely kisses
with cats, dogs, puppies, and pigs, can all contribute to
causing Campylobacter disease.
What are the risk factors for developing Campylobacter
because of course, this organism is somewhat ubiquitous?
Pretty much having a lack of gastric acids or those who are
acking either a humoral response, an antibody or
or those rare individuals who are complement deficient.
Acute gastroenteritis caused by Campylobacter is unpleasant
It’s perhaps not the most severe gastroenteritis in the
certainly not when compared to Salmonella or Shigella but it
is all by itself plenty unpleasant.
Typical patients will have a watery, scantily bloody
diarrhea along with vomiting and fever
is certainly along with malaise which may last up to one
Along with the gastrointestinal complaints, there is crampy
abdominal pain all over
and there may even be purulent material or pus in the stool.
Here is the mention of the autoimmune diseases that I had
briefly discussed before.
Molecular mimicry to structures of the Campylobacter cell
wall will trigger antibody production
which in some patients may precipitate Guillain-Barre
excuse me, an ascending paralysis as well as reactive
arthritis, typically in patients who are HLA-B27 positive.
Now, the risk for developing Guillain-Barre or
post-infectious reactive arthritis is not equal going both
While many patients with Guillain-Barre syndrome
for example have had Campylobacter infection preceding the
onset of their disease,
it is not true that many Campylobacter infected patients
will develop Guillain-Barre.
In fact, the overall or relative risk for developing
or post-infectious reactive arthritis if one develops
Campylobacter infection is quite low.
Prevention, treatment, and also, diagnosis.
So, as I mentioned before, Campylobacter has very specific
and if one is ordering stool cultures to look for
Campylobacter, one has to specifically request the so called
a Campylobacter plate which will tell the lab to grow that
particular agar or culture source at 42 degrees Celsius
and in a carbon dioxide enriched environment.
Treatment for Campylobacter is most often accomplished with
a macrolide antibiotic
such as erythromycin or azithromycin or secondarily, a
Now, for those of you who have taken erythromycin for
treatment of an infection,
you may realize that sometimes the treatment is worse than
Macrolides frequently are associated with their own
perhaps, making the patient far more miserable than they
Most patients do not require antibiotic treatment for
Campylobacter as it does resolve spontaneously.
The principal effect of treatment needs to be to maintain
hydration and replace any loss of nutrients or electrolytes.
So, Campylobacter, remember, seagull-shaped,
special growth requirements in a carbon dioxide enriched
environment and warm,
and potentially, a risk factor for developing Guillain-Barre
or post-infectious reactive arthritis, and that my friends