What Are the Symptoms of Campylobacteriosis?

Campylobacterosis

Campylobacter that infects humans and causes disease include Campylobacter jejuni, Campylobacter colon, and Campylobacter fetus. Campylobacter kongi and Campylobacter colon are mainly responsible for acute enteritis. Campylobacter fetus is mostly an opportunistic infection, which can cause systemic diseases such as sepsis.

Campylobacter disease name

Campylobacterosis

Campylobacter disease overview

Pathogenic mechanism and symptoms : The mechanism of Campylobacter causing human enteritis is not fully understood, and may be related to its invasiveness, endotoxin and exotoxin. Two volunteer subjects abroad, one case showed typical symptoms three days after oral administration of milk with a bacterial content of 106; the other case developed foods with an oral bacterium content of 500 on the fourth day. Campylobacter jejuni enters the digestive tract from the mouth, and gastric acid has a certain killing effect on fasting. It has been proven that solutions with a pH 3.6 kill the bacteria. Therefore, full meals or foods are good for bacteria to break through the gastric barrier. Bacteria that enter the intestinal cavity multiply in the upper small intestine cavity and invade the mucosal epithelial cells by their invasive force. Bacteria grow and reproduce to release exotoxin, and bacteria lyse out endotoxin. Exotoxin is similar to cholera enterotoxin. Exotoxin activates adenylate cyclase in epithelial cells, which in turn increases cAMP and increases energy, which promotes strong secretion of mucosal cells and causes diarrhea. This effect can be blocked by cholera antitoxin. The growth and reproduction of germs and toxins also cause local mucosal congestion, exudation, edema, ulcers, and bleeding. If immunity is low, bacteria can spread with the bloodstream, causing bacteremia, or even sepsis, which in turn can cause damage to the brain, heart, lungs, liver, urinary tract, and joints.

Campylobacter disease classification

Infectious Diseases

Campylobacter symptoms and signs

1. Campylobacter jejuni infection

The incubation period ranges from 1 to 7 days, with an average of 3.5 days. It can also manifest as severe enterocolitis. Most patients have general discomfort, fatigue, chills, fever, and body temperature of 38 ° C-40 ° C. Local symptoms are mainly abdominal pain and diarrhea. Abdominal pain is mostly located around the umbilicus or upper abdomen, showing intermittent colic. The stool does not change 2-10 times a day, the stool is watery or mucus, and the heavy pathology has mucus and bloody stools. The course of the disease is generally 7-10 days, and there are also people up to 6 weeks, a few can develop chronic diarrhea. In addition, some soldiers can objectively appear peritonitis, cholecystitis, arthritis, and appendicitis. It can also be combined with hemolytic uremic syndrome, polyneuritis, Guillain-Barre syndrome, meningitis, endocarditis, thrombophlebitis, and urinary system infection.

Campylobacter fetus infection

Most of them are symptoms of extra-intestinal infection, and the common clinical symptoms are sepsis or bacteremia. It can also cause endocarditis, pericarditis, lung infections, arthritis and other local infections. Central nervous system infections can occur in newborns and the elderly, manifested as meningoencephalitis, subdural effusion, and swelling of the brain. Adults can also manifest as strong hemorrhage outside the cerebrovascular and subarachnoid. Infection in the second trimester can cause stillbirth and abortion.

Campylobacter disease cause

1. Sources of infection Patients and carriers are the source of the disease. Most wild and domestic animals, including poultry, livestock, and birds can be infected with Campylobacter, causing clinical symptoms and even death. Most infected animals can be infected for life or become a source of Campylobacter infection.

2. The way of transmission is mainly through contamination of food or water, oral transmission, or through contact.

3. The susceptible population is generally susceptible. In developed countries, the peak age of onset is <1 year old infants and 20-29 years old. In developing countries, the incidence rate is mainly <2 years old children. The number of cases decreases with age .

4. Epidemic characteristics Campylobacter infection is more common. In patients with acute enteritis, the detection rate of Campylobacter jejuni is generally 5% -14%. Infection and disease can occur throughout the year, but the season is more common. Campylobacter jejuni infection can be seen in previous healthy people. Campylobacter fetus infection is mainly used in patients with low immunity, such as chronic liver disease, diabetes, hypogammaglobulinemia, malignant tumors, AIDS and elderly patients.

Campylobacter pathophysiology

The pathogenesis of Campylobacter jejuni infection is unknown. After oral ingestion of bacteria, the small intestine proliferates through the gastric acid barrier, which invades its invasion (including flagella and bacterial surface proteins) into the intestinal mucosa, causing intestinal mucosal damage. Bacteria-produced toxins and enterotoxins may also be associated with diarrhea. Campylobacter jejuni mainly causes local lesions of the intestinal mucosa. Generally does not invade the bloodstream. Intestinal lesions can occur in the jejunum, ileum, and colon, and are mainly non-specific inflammatory reactions with neutrophil and plasma cell nuclear infiltration. Intestinal mucosal edema, punctate hemorrhage, superficial ulcer, crypt abscess, etc. can be seen. The surface of Campylobacter is covered with a lonely structure composed of surface protein (S protein), which makes it resistant to defense mechanisms such as complement-mediated sterilization and detachment. Therefore, Campylobacter fetus infection can easily cause bacteremia and extra-intestinal organs. The infection is also prone to chronic or recurrent symptoms.

Campylobacterosis diagnostic test

I. Laboratory inspection

(1) Routine examination The stool examination can be watery stool or mucus bloody stool, and a small amount of white blood cells, red blood cells, pus cells, etc. can be seen by microscopy. There may be a slight increase in the total number of cells and neutrophils in the blood routine.

(II) Pathogen inspection

1. Direct examination of fecal civil construction by Gram staining or Rayleigh staining. Under the microscope, slender S-shaped, spiral, comma, or seagull wing-shaped drop-shaped bacilli can be seen. Hanging drops of stool can also be used to observe Bacteria power.

2. Fecal culture Inoculate feces on a selective culture medium and cultivate them in a micro-oxygen environment at 42 ° C to obtain pathogenic bacteria.

(3) Serological examination should take serum as agglutination test to check O and H K antibodies. Patients with a serum antibody recovery rate of more than four times during the recovery period have a diagnosis.

2. Diagnosis

Diagnosis can be based on epidemiological history, clinical manifestations such as abdominal pain and diarrhea. Definite diagnosis and stool pathogen examination.

Campylobacter treatment plan

(A) general and symptomatic treatment

Isolation by infectious diseases of digestive tract, bed rest during acute phase, high-calorie, high-nutrition, easy-to-digest diet. People with high fever can be physically cooled, and patients with severe signs of dehydration should be replenished to maintain water and electrolyte balance.

(Two) pathogen treatment

1. Campylobacter jejuni infection should be treated as soon as possible, erythromycin is preferred, 0.8-1.0 g daily for adults, 40-50 mg / kg daily for children, and oral 5-7 days. Can also choose doxycycline, tetracycline, fluoroquinolone antibiotics, chloramphenicol, fosfomycin, aminoglycoside antibiotics and so on.

2. For Campylobacter fetus infection, aminoglycoside antibiotics such as gentamicin and other sensitive antibiotics such as ampicillin can be selected. Patients with sepsis should be treated with effective antibiotics for at least one week. Central nervous system infection can be treated with ampicillin and / or chloramphenicol for 2-3 weeks.

Campylobacter disease prevention

Pay attention to food management and drinking water hygiene to prevent intensification and contamination of livestock manure. Strict disinfection of milk excretion of patients.

Campylobacter Safety Tips

1. Food practitioners, childcare workers and health workers should leave work until the physician determines that they are not contagious. Infants and children with disabilities, those who have difficulty taking care of themselves, should be at home until they fully recover. Most infected people can go back to work after the feces have formed, but they should wash their hands, especially after defecation.

2. General treatment: In addition to physical cooling, antipyretics can be given appropriately. Those with severe abdominal pain are given antispasmodics. Oral rehydration can be given to those who are dehydrated. In severe cases, intravenous fluids can be given.

3. Eating food contaminated by bacteria (especially chicken or raw milk), or drinking unclean water, or contacting pets (especially kittens, puppies) or other patients (especially infected babies) infection.

Specific prevention :

1. Avoid infection. Cook meat and poultry thoroughly. The birds are cooked to an internal temperature of at least 73.9 ° C. After cutting raw poultry food, the cutting board should be carefully brushed.

2. Do not drink untreated water (streams, lakes, ponds, etc.). Do not drink unsterilized milk and dairy products.

3. Wash your hands thoroughly after changing diapers, especially before preparing food.

4. Wash your hands after handling pet faeces. Children must not touch animal droppings.