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Chapter 6 : Clinical Aspects of and Infections

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Abstract:

This chapter describes the clinical aspects of infection with ( subsp. ) and , which are the main causes of enteritis in humans. The prodrome can be highly misleading in the absence of abdominal symptoms, which may not appear for two or even three days. Patients with prodromal symptoms tend to have more severe illness than those whose illness starts with diarrhea. The chapter discusses special aspects of infection, intestinal complications, and extraintestinal infection. The urinary tract seems an unlikely place to find campylobacters because they do not tolerate acid conditions well, but there are two reports of apparent urinary infection. In the first, the main site of infection was thought to be the prostate, but in the other, there appeared to be cystitis in a 6-year-old girl. Infections will be missed unless cultures specific for campylobacters are set up when morphologically suspect bacteria are seen in urine samples. The association of enteritis with Guillain-Barré syndrome, which emerged during the mid-1980s, greatly improved one's understanding of the morbidity of the disease. The chapter also describes the role of endoscopy and rectal biopsy in the management of patients. No specific treatment is required for most patients with enteritis, other than the oral replacement of fluid and electrolytes lost through diarrhea and vomiting. Erythromycin was the first antimicrobial agent to be used. Serious systemic infection should be treated with an aminoglycoside, such as gentamicin, or imipenem.

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6

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Infectious Diseases
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Campylobacter jejuni
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Campylobacter coli
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Image of Figure 1.
Figure 1.

Diagram illustrating an overview of illnesses due to and .

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
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Image of Figure 2.
Figure 2.

Diagram illustrating the typical course of enteritis. Reprinted from D. Greenwood, R. Slack, and J. Peutherer (ed.), , 15th ed. (Churchill Livingstone, Edinburgh, 1997).

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
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Image of Figure 3.
Figure 3.

Distribution of bacteremia cases in England and Wales, 1981 to 1991. Solid line indicates number of cases (n = 374); dashed line, cases per 1,000 intestinal infections. Reprinted from .

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
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Image of Figure 4.
Figure 4.

Trends in quinolone resistance rates among and isolates from humans from 11 countries, 1989 to 2006. The bars represent both nalidixic acid and fluoroquinolone resistance and are based on mean values of resistance from numerous reports. Year in parentheses is year of licensure for use in veterinary medicine in each country. Canada and the United States banned veterinary use of fluoroquinolones in 1997 and 2005, respectively. Updated and modified from . References therein plus the following: ); , 2004b, ); ); ); ; Prouzet-Mauléon and Mégraud (personal communication); J. Engberg (unpublished data).

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
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Tables

Generic image for table
Table 1.

Clinical features of enteritis derived from surveys of community outbreaks in which 50 or more people were affected and analyzed

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
Generic image for table
Table 2.

Comparison of histological features that help to differentiate and other infective causes of proctocolitis from acute inflammatory bowel disease (IBD)

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
Generic image for table
Table 3.

Focal infections due to and

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
Generic image for table
Table 4.

Macrolide resistance among and and combined, isolated from human sources around the world since 1997

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6
Generic image for table
Table 5.

Studies evaluating the duration of illness in patients infected with quinolone-resistant or quinolone-susceptible strains

Citation: Blaser M, Engberg J. 2008. Clinical Aspects of and Infections, p 99-121. In Nachamkin I, Szymanski C, Blaser M (ed), , Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815554.ch6