Campylobacter - Microbial Food Poisoning

 Campylobacter

While E. coli is the commonest cause of diarrhoea in Third World countries such as India, Campylobacter accounts for a significant number of cases, and rotavirus comes in at a close third. The Campylobacter species responsible for food poisoning include C. jejuni, C. coli, and C. lari.

Source

·              Undercooked meat products: chicken, beef, mutton, turkey, etc.

·              Unpasteurised milk and milk products.

·              Unchlorinated water.

Incubation Period

·              About 1 to 7 days.

Clinical Features

·              Like E. coli, Campylobacter is a common cause of “traveller’s diarrhoea”.

·      Watery or bloody diarrhoea.

·      Vomiting.

·      Abdominal pain.

·      Fever, malaise, headache.

·      The illness usually lasts for 5 to 6 days, but may sometimes persist for several weeks.

Complications

·              GI haemorrhage.

·              Haemolytic uraemic syndrome.

·              Meningitis.

·              Reactive arthritis.

·              Acute anterior uveitis.

·              Erythema nodosum.

·              Septicaemia (extremes of life, immunocompromised patients).

Diagnosis

■■   Microscopy of stool sample: Leukocytes are frequently seen. Phase contrast or dark field microscopy will reveal the characteristic darting or tumbling motility of the small, curved, rod-like bacteria in stained smears.

■■   Stool culture.

■■   Graded compression ultrasonography of the right lower abdominal region may show mural thickening of terminal ileum and caecum.

■■   Sigmoidoscopy: Oedematous, hyperaemic mucosa with shallow grey-based aphthous ulcers.

Treatment

■■   Rehydration.

■■   Erythromycin ethyl succinate, 400 mg, four times a day, decreases faecal shedding of the organism, but may not shorten the duration or severity of symptoms. Ciprofloxacin can also be used.

■■   Anticholinergics and opiates are contraindicated.