History and exam
Key diagnostic factors
common
presence of risk factors
Key risk factors include: HIV infection; male sex; age <1 year; exposure to poultry, cattle, sheep, or other farm animals; eating raw or undercooked meat (especially chicken); recent foreign travel; travel to developing countries; drinking well or surface water; drinking unpasteurised milk; and taking proton pump inhibitors or H₂ antagonists.
abdominal pain
The abdominal pain associated with Campylobacter infection is usually more severe than that with the other bacterial causes of enteritis/colitis. The pain often becomes continuous and radiates to the right iliac fossa (frequently described as right lower quadrant of the abdomen).[32]
diarrhoea
The major clinical manifestation of Campylobacter infection is diarrhoea. The diarrhoea may be watery, with up to 8-10 bowel movements daily. It becomes bloody in approximately 20% to 25% of cases. The diarrhoea is considered inflammatory because of the prominent expression of fever and constitutional symptoms, and because the stools contain leukocytes and blood.[4]
Other diagnostic factors
Risk factors
strong
recent foreign travel
Risk of infection is highest in people who have visited Africa, Asia, and South America, particularly areas with poor sanitation and restaurant hygiene.[14]
eating raw or undercooked meat (especially chicken)
exposure to poultry, cattle, sheep, or other farm animals
Infection can be acquired directly from animals or their carcasses. This type of direct transmission is usually occupational and occurs in farmers, slaughterhouse workers, and poultry processors. Domestic infection can also occur from contact with a pet (puppy or kitten) with diarrhoea.[23]
HIV infection
Incidence of Campylobacter infection is increased in patients with HIV/AIDS, although the incidence is lower in HIV-positive patients on antiretroviral therapy.[5] People with HIV are also at risk of becoming long-term carriers of Campylobacter. This is associated with recurrent enteritis and bacteraemia.[25]
weak
drinking untreated water
Drinking untreated water and swimming in recreational water carries a risk of transmission.[18]Campylobacterwas responsible for 36 out of 123 waterborne outbreaks in Nordic countries between 1998 and 2012.[26] In 2022, there were a total of 19 active cases of Campylobacter infection in Montana, USA, caused by the consumption of untreated water.[27]
drinking unpasteurised milk
In one study, 5% of cases of Campylobacter infection occurred from drinking unpasteurised milk. It is nearly impossible to prevent milk from becoming faecally infected; therefore, pasteurisation is necessary to prevent transmission.[28]
close contact with infected person
People with Campylobacter infections do not need to be isolated. As the infection is acquired by faecal to oral transmission, person-to-person spread of infection is highly unlikely. However, hand-washing is still important when in close contact with a person with a diarrhoeal illness. Also, people with a diarrhoeal illness should not handle food.
use of proton pump inhibitors or H2 antagonists, especially in older patients
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