Campylobacter jejuni was first isolated from the feces of diarrhea patients by Butzler et al. in 1973 and is now recognized as one of the major pathogenic bacteria causing human diarrhea. The incidence of Campylobacter jejuni enteritis exceeds that of bacterial dysentery in developed countries and is nearly equal to bacterial dysentery in developing countries.

bubble_chart Pathogen

Campylobacter jejuni can cause diarrhea in humans and animals. The species related to humans include Campylobacter jejuni, Campylobacter fetus, and Campylobacter small intestine, with Campylobacter jejuni being the most pathogenic. The bacteria are slender, curved, spiral, or comma-shaped, Gram-negative, and thrive in microaerobic environments at 42°C.

bubble_chart Pathogenesis

After entering the intestine, the bacteria rapidly multiply in a microaerobic environment, primarily invading the jejunum, ileum, and colon, attacking the intestinal mucosa, causing congestion and hemorrhagic injury. In recent years, it has been observed that some strains can produce a cholera-like enterotoxin, leading to increased fluid secretion in the intestinal lumen.

bubble_chart Clinical Manifestations

The onset is acute, with fever, abdominal pain, diarrhea, nausea, and vomiting. In mild cases, the diarrhea presents as watery stools, while in severe cases, the stools contain mucus, blood, and pus, resembling bacterial dysentery, or even bloody stools. Bowel movements occur 6–10 times a day, with small volumes, but in severe cases, they can reach up to 20 times. Foreign reports indicate that bloody stools occur in 60–90% of children with Campylobacter jejuni enteritis, while domestic reports show a rate of 3–10%, possibly due to different pathogenic strains. During the course of the illness, complications such as mesenteric lymphadenitis, appendicitis, cholecystitis, or sepsis may occur.

A rapid diagnosis can be made by observing rapidly moving curved bacteria under a dark-field microscope or related microscope using fresh feces. Confirmation relies on fecal culture.

bubble_chart Treatment Measures

Most patients recover on their own but continue to shed bacteria for several months, with the longest recorded shedding period lasting up to one year. Antibiotic treatment can quickly control diarrhea and stop bacterial shedding. Options include amikacin, gentamicin, and amoxicillin. Symptomatic treatment should also be emphasized, with rehydration for those experiencing dehydration.