Campylobacter

CASE 1

• A 28 year old woman has diarrhea with fever and lower abdominal pain. She has had an occasional stool with blood in it. Her husband has had a similar illness.

• She was asked about her recent food and drink in the household and reported the following history: Three days earlier she bought a chicken from a local cold store to prepare groundnut soup. After cleaning the chicken pieces, she used the same knife to chop cabbage, carrots, and cucmbers for a cold salad without washing it. The salad was eaten by her husband and herself but not by her two young children, neither of whom became ill.

• If you performed a Gram stain of her stool, you might see a preponderance of slightly curved or S-shaped bacteria in pairs, attached end-to-end, giving the impression of a bird in flight ("gull-wing" forms). This is characteristic of Campylobacter.

Questions:

1. What was the food vehicle that transmitted this pathogen to this couple?
2. What was the original source of the organism? Is chicken a common source? What are some other source of this pathogen?
3. Will refrigeration or freezing kill an enteric pathogen, or preserve it?
4. If you suspect that the diarrhea was due to Campylobacter jejuni, what special conditions are required to culture this organism from the stool?
5. Some individuals with Campylobacter diarrhea may subsequently develop an immunologically-based neurological complication. What is it?