Campylobacter organisms are microaerophilic, motile, gram-negative rods. Two species infect humans: Campylobacter jejuni, an important cause of diarrheal disease, and C fetus subsp fetus, which typically causes systemic infection and less frequently gastroenteritis. Dairy cattle and poultry are an important reservoir for campylobacters. Outbreaks of enteritis have been associated with consumption of raw milk. Campylobacter gastroenteritis is associated with fever, abdominal pain, and diarrhea characterized by loose, watery, or bloody stools. The differential diagnosis includes shigellosis, Salmonella gastroenteritis, and enteritis caused by Y enterocolitica or invasive E coli. The disease is self-limited, but its duration can be shortened with antimicrobial therapy. Either azithromycin, 1 g orally as a single dose, or ciprofloxacin, 500 mg orally twice daily for 3 days, is effective therapy. However, C jejuni isolates may be resistant to fluoroquinolone, particularly in Southeast Asia, and susceptibility testing should be routinely performed.
C fetus causes systemic infections that can be fatal, including primary bacteremia, endocarditis, meningitis, and focal abscesses. It infrequently causes gastroenteritis. Patients infected with C fetus are often older, debilitated, or immunocompromised. Closely related species, collectively termed “campylobacter-like organisms,” cause bacteremia in HIV-infected individuals. Systemic infections respond to therapy with gentamicin, carbapenems, ceftriaxone, or ciprofloxacin. Ceftriaxone, meropenem, or chloramphenicol should be used to treat infections of the CNS because of their ability to penetrate the blood-brain barrier.
et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65:1963.