Microbiology

Campylobacter Jejuni Diarrhea Appendicitis Pseudoappendicitis



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The Campylobacter genus belongs to the gastrointestinal gram negative rod family of bacteria, and the most renowned species of bacteria under the family is Campylobacter jejuni, a well known cause of pseudoappendicitis, the mimicking of appendicitis without the actual inflammatory reactions taking place at the appendix, accompanied by either bloody or non bloody diarrhea. The epidemiology, pathogenesis, clinical significance, and treatment of Campylobacter jejuni would be discussed in depths in this article.



Animals such as mammals and fowls, both natural and domestic, serve as the primary natural reservoir of Campylobacter. Upon killing of these animals (for example a wild bird) and the consumption of its meat, the bacteria may be transmitted from the animal to human. Since mouth in this case serves as the portal of transmission, this method of spreading is known as the fecal oral route. One should also note that the consumer does not have to eat the meat of the infected animal directly; drinking of water contaminated by the infected animal may produce the same cause as well. Thus, the epidemiologic transmission may be either direct or indirect from animals to humans.



The most clinically well recognized manifestation of Campylobacter jejuni is pseudoappendicitis accompanied by either bloody or non bloody diarrhea. Needless to say, the patient experiences acute pain in the right one third of the groins when manifestation becomes pronounced. The point at which the pain is felt is medically termed the McBurney's Point. This manifestation must be carefully distinguished from that of the bacteria Yersinia Enterocolitica and Pseudotuberculosis, which are manifested by pseudoappendicitis but no diarrhea. Other less specific manifestations of Campylobacter jejuni may include fever and bacteremia. Septic abortion, reactive arthritis, and Guillain Barre syndrome are also some other less clinically important signs of infection.



Campylobacter jejuni may be identified with laboratory techniques such as the culture in microaerophilic medium. Due to the fact that the microorganism require little yet some oxygen for its survival, the culture of one's stool samples in microaerophilic culturing media may prove effective. Also, the bacteria is also of extremely small size. Utilizing that fact to one's advantage, a clinician may use a bacteriologic filter for the separation. Thanks to its small size, Campylobacter jejuni should be filtered through the filter, leaving other larger bacteria behind in the stool sample.



The treatment of Campylobacter jejuni should be targeted both against its symptoms and the causative microorganism. The diarrhea requires the replacement of water and electrolyte; the failure to do so may result in hypovolemia and possibly its consequent hypovolemic shock. The microorganism is sensitive to many antibiotics, but the drug of choice is ciprofloxacin. In times when such administration is not possible, alternative administration of ampicillin or third generation cephalosporin should be pursued.

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