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Clinical manifestations, diagnosis, and treatment of Campylobacter infection

Ban M Allos, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


Campylobacter infection is an important cause of acute diarrhea worldwide; the organism also may produce systemic illness. Campylobacter enteritis is typically caused by Campylobacter jejuni or Campylobacter coli. The organism inhabits the intestinal tracts of a wide range of animal hosts, notably poultry; contamination from these sources can lead to foodborne disease. Campylobacter infection can also be transmitted via water-borne outbreaks and direct contact with animals or animal products.

Issues related to clinical manifestations, diagnosis and treatment of Campylobacter infection will be reviewed here. Issues related to microbiology, pathogenesis, and epidemiology of Campylobacter infection are discussed separately, as are issues related to less-common Campylobacter species. (See "Microbiology, pathogenesis, and epidemiology of Campylobacter infection" and "Infection with less common Campylobacter species and related bacteria".)


The clinical features of Campylobacter enteritis due to C. jejuni and C. coli are clinically indistinguishable from one another and from illness due to other bacterial pathogens, such as Salmonellae or Shigellae.

Adults — The mean incubation period is three days (range one to seven days) (figure 1) [1-3]. Early symptoms include abrupt onset of abdominal pain and diarrhea. In about one-third of cases, a prodromal period characterized by high fever accompanied by rigors, generalized aches, dizziness, and delirium is observed. It may last for one day (rarely two or three days) prior to onset of gastrointestinal symptoms. Patients presenting with prodromal symptoms tend to have more severe disease than those presenting with diarrhea.

The acute illness is characterized by cramping, periumbilical abdominal pain, and diarrhea. Patients frequently report ten or more bowel movements per day [4]. Bloody stools are observed on the second or third day of diarrhea in about 15 percent of patients; infection with an organism containing plasmid pVir may be correlated with more severe invasive disease and higher likelihood of bloody diarrhea [5,6]. Abdominal pain also may occur without diarrhea [7]. The pain may become continuous and radiate to the right iliac fossa, mimicking acute appendicitis. Nausea is common; approximately 15 to 25 percent of patients report vomiting.


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