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Campylobacter Enteritis

Article
Digestive Health
Diseases & Conditions
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Contributed byMaulik P. Purohit MD MPHAug 09, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Bacterial Diarrhea caused by Campylobacter
  • Campylobacter Gastrointestinal Tract Infection
  • Food Poisoning - Campylobacter Enteritis

What is Campylobacter Enteritis? (Definition/Background Information)

  • Campylobacter Enteritis, also known as Infectious/Bacterial Diarrhea, is a common dehydrating condition caused by consuming food and water that is infected by a (gram negative) bacteria, called Campylobacter jejuni
  • This bacterial infection causes severe diarrhea (maybe accompanied by vomiting), thereby draining the body of vital fluids and causing pain and inflammation of the stomach and intestines
  • Remedial measures are mostly related to compensating the lost body fluids, either orally or intravenously, controlling related symptoms (such as fever and abdominal pain) with antibiotics, and taking plenty of rest
  • Delayed or improper treatment of the condition could cause acute problems requiring hospitalization and extended medication course

Who gets Campylobacter Enteritis? (Age and Sex Distribution)

  • Any individual, young or old, may contract Campylobacter Enteritis. There is no age or gender preference, it is only dependent upon the consumption of contaminated food or water
  • However, statistics associate children and young adults, as being most prone to the infection
  • Travelers are at risk, particularly those visiting regions where proper sanitation facilities are absent, and the quality of food/water is poor, or cannot be trusted

Due to this reason, the infection is also termed as Traveler’s Diarrhea. The term Traveler’s Diarrhea is used for infections, caused by other bacterial organisms too.

What are the Risk Factors for Campylobacter Enteritis? (Predisposing Factors)

The risk factors of Campylobacter Enteritis include:

  • Consuming food that is raw (milk and milk-products, unwashed fruits/vegetables, eggs), is partially cooked (chicken, meat, eggs, fish, pork), or cooked improperly (without maintaining proper hygiene standards), or not stored (or refrigerated) well
  • Drinking untreated (or non-chlorinated) water from a stream, or a well, or from any such source
  • Consuming beverages from street sellers/vendors, who prepare them without standard food safety precautions
  • Living or travelling to areas with poor sanitation facilities
  • Eating food that is mass-prepared, without proper quality control
  • A weakened immunity system (due to AIDS/HIV, cancer, organ transplant, diabetes, and immunosuppressive treatments ) is easily infected

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Campylobacter Enteritis? (Etiology)

Ingesting contaminated food that is improperly cooked, or drinking unclean water, is the primary cause of Campylobacter Enteritis.

  • Campylobacter jejuni bacteria is responsible in most cases of causing this condition, though another bacteria, Campylobacter coli is also responsible to a lesser extent
  • Both these bacteria are present naturally within the stomach and guts of most domesticated animals (dogs, cats) and farm animals, specifically the poultry birds. The transmission route for these entering into the human body system include:
    • Contaminated food and water
    • Direct or indirect contact with the animals/birds (such as accidental ingestion of their feces)
  • Often, when food prepared for a community is contaminated, like at restaurants, school dormitories, for social or festival occasions, the condition may simultaneously affect a large group of individuals
  • Some of the reasons why food/water get contaminated with germs are because of improper handling, preparation, and cooking, the use of bacteria-infected dairy, fish, and meat products, consuming raw vegetables and fruits, etc.
  • Consuming contaminated water from poor sources and storage conditions is also a major cause of infection

What are the Signs and Symptoms of Campylobacter Enteritis?

Diarrhea (of watery consistency) is the most common sign of food poisoning. The other signs and symptoms of Campylobacter Enteritis, which start in less than a week’s time (2-4 days) of the infection include:

  • Abdominal pain and cramps
  • Watery or mucus laden stools, blood in the stools
  • Stomach pain
  • Dehydration
  • Nausea and vomiting
  • Drowsiness, exhaustion
  • Fever

How is Campylobacter Enteritis Diagnosed?

Normally, a case of Campylobacter Enteritis is easily recognized from its clinical presentation, though differential diagnostic tests may be required to determine the exact type of bacteria that caused the condition. The physician performs a physical examination to study for any indications of food poisoning, or to learn about the body’s dehydrated state.

Some of the exams and tests conducted include:

  • Stool examination/culture - to check for any white blood cells, or the bacterial type involved in the infection
  • Blood test (total blood count)
  • Blood cultures, to determine the cause of signs and symptoms
  • Analysis of the problem ‘food’ sample, to find the type of bacteria causing the infection

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Campylobacter Enteritis?

The most frequent and main complication of the intestinal infection due to Campylobacter, is dehydration. This leads to severe malnutrition and malabsorption, when the intestine loses its capacity to properly absorb carbohydrates, fats, minerals, and nutrients, into blood.

A few other potentially serious medical issues that can develop, if the infectious diarrhea is not controlled, or if other secondary health conditions are present, include:

  • Guillain-Barre syndrome (rare condition of the nervous system), sepsis, endocarditis, eye infection, arthritis, urinary tract infection, toxic megacolon
  • Development of irritable bowel syndrome: In case an individual already suffers from irritable bowel syndrome, the presence of Campylobacter enteritis, can make it worse
  • Some of the bacteria are retained in the body even on recovery, which may get reactivated when conditions are conducive. Some individuals may develop a chronic case of Campylobacter Enteritis. In these cases, such individuals are classified as a reservoir of Campylobacter bacteria

How is Campylobacter Enteritis Treated?

  • Most cases of Campylobacter Enteritis are self-limiting, meaning that an individual usually recovers from the condition within a week’s time. The recovery time may be longer if other complications, such as severe dehydration occur
  • Having plenty of rest, drinking lots of fluids, and controlling other symptoms, like nausea and vomiting, are helpful in feeling generally comfortable and aids in recovery
  • Slight modifications to diet are advised to prevent further aggravation of the condition. An improper diet may create additional complications
  • If diarrhea is severe and is accompanied by vomiting leading to exhaustion, then the lost fluids may have to be replenished intravenously. This is commonly seen in young children. Young children and the elderly may need to be rehydrated orally, at regular intervals, and be constantly observed/monitored
  • Normally, antibiotics are not prescribed for gastroenteritis. However, certain antibiotic drugs may be prescribed to avert complications and bring the infection under control
  • Over-the-counter drugs are available to arrest diarrhea; however, it is best to consult a physician before using them. The use of over-the-counter medications should be under physician supervision, if the diarrhea is severe, or if the affected individuals are young children
  • Individuals with a weak immune system have to treated symptomatically, but aggressively

How can Campylobacter Enteritis be Prevented?

  • To reduce the incidence of Campylobacter Enteritis, proper precautions have to be taken to prevent transmission of the harmful bacteria, via food and water. This is even more essential, while traveling to other countries/regions/cities
  • Vaccinations are recommended for travelers to other parts of the world, especially to regions having high potential for such infections
  • Avoiding undercooked or raw food, and contaminated water may help in preventing food poisoning, that leads to diarrhea and other symptoms
  • Follow basic rules while cooking food, such as carefully washing food items (like meat and vegetables), washing food vessels before use, cooking meat to the required temperatures to kill any bacteria, refrigerating cooked food to avoid it being spoiled, keeping food items covered, etc.
  • Always drink water that is clean and from a reliable source. Also, take pasteurized milk, instead of raw milk

What is the Prognosis of Campylobacter Enteritis? (Outcomes/Resolutions)

  • A healthy and normal individual usually recovers from Campylobacter Enteritis within a few days, even if no treatment is availed and only certain basic self-care stepsare followed (like, drinking enough fluids, getting some rest, etc.)
  • If the body is severely drained of fluids leading to malnutrition, then hospitalization may be required. The condition may turn serious, if the patients are newborn babies, very young infants, the elderly, or if they were already ill
  • Mortality rate with bacterial diarrhea is low, if the condition is managed properly. However, secondary complications and the lack of proper healthcare may affect adversely, causing life-threatening situations
  • Infants (below age one year), the elderly individuals, and the immunocompromised, may develop serious to fatal conditions

Additional and Relevant Useful Information for Campylobacter Enteritis:

  • In many geographical regions of the world (mainly the lesser industrialized nations), where the healthcare system lacks the kind of preparation and resources needed to treat dehydration, caused by vomiting and diarrhea, the mortality rates due to Campylobacter Enteritis is high
  • The management (prevention and treatment) of the infection can be accomplished to a good extent through mass education. This should include information on:
    • Proper hygiene
    • Good food preparation practices
    • Understanding the value of oral rehydration techniques in providing early relief
    • Simple and easily available remedial steps to prevent aggravation of the condition
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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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