Campylobacteriosis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Campylobacteriosis is an acute infectious disease occurring with a primary lesion of the digestive system. It is widespread and of considerable epidemiological significance. Among the general incidence of acute intestinal infections, the proportion of campylobacteriosis is 10-15%.
The disease is recorded in all countries of the world, including the Russian Federation, both in the form of group and in the form of sporadic cases. Most often, preschool children get sick with campylobacteriosis. The peak incidence occurs in the summer-autumn period.
Pathogenic intestinal enterobacteria of the genus Campylobacter - the causative agent of campylobacteriosis
Causes and risk factors
The causative agent of campylobacteriosis is pathogenic intestinal enterobacteria of the genus Campylobacter. At present, about 15 species of these bacteria have been described, isolated from animals and humans. The greatest epidemiological significance among them is C. jejuni and C. coli, which cause diarrheal forms of the disease, and C. fetus, which causes hematogenous disseminated form of infection.
Campylobacteriosis is a typical zoonotic infection originating from poultry and animals. The main route of transmission of infection is alimentary, that is, human infection occurs as a result of eating milk, water, and meat contaminated with enterobacteriaceae. Also, infection can occur as a result of a human bite by an infected animal (transmissible route). Campylobacteriosis pathogens have the ability to cross the placental barrier and cause disease in newborn babies.
The risk group for contracting campylobacteriosis includes:
- workers of poultry and livestock farms;
- villager;
- the population of developing countries, as well as tourists visiting these countries;
- pregnant women;
- children;
- people with reduced immunity.
Farm workers and villagers are at risk of contracting compilobacteriosis
Campylobacter, once in the human body, is initially introduced into the lymphoid formations and the mucous membrane of the small intestine, causing an inflammatory process. Then they migrate along the lymphatic tract and penetrate into the large intestine, the appendix, the lymph nodes of the mesentery.
In the process of their vital activity, campylobacter forms cyto- and enterotoxins, which become the cause of the development of intoxication, pain and diarrheal syndromes.
In patients with immunodeficiency states, campylobacteriosis can turn into a generalized form, which is accompanied by the development of septicopyemia and septicemia, the formation of abscesses in the spleen and liver, and multiple organ failure.
Forms of the disease
According to the prevalence of the infectious process, generalized and gastrointestinal (localized) forms of campylobacteriosis are distinguished. The generalized form of the disease is accompanied by septicopyemia and septicemia. The gastrointestinal manifestations of campylobacteriosis include:
- appendicitis;
- mesentery;
- enteritis;
- enterocolitis;
- gastroenterocolitis;
- gastroenteritis.
According to the characteristics of the clinical course, an asymptomatic and manifest form of campylobacteriosis is distinguished.
According to the duration of the course, the disease is divided into the following forms:
- acute (less than 3 months);
- chronic (over 3 months);
- residual (the pathological process stops, but some of its signs remain in the clinical picture).
Symptoms
Campylobacteriosis in most cases is localized, that is, the infection does not go beyond the gastrointestinal tract. The duration of the incubation period is on average 2 to 5 days.
The disease begins acutely, with the appearance of headaches and muscle pains, chills, an increase in body temperature to 38-39 ° C. At the same time, or somewhat later, diarrhea occurs with a frequency of bowel movements up to 15 times per day, which is accompanied by cramping pain in the abdomen. The feces are watery, with a fetid odor, may contain impurities of blood, mucus, bile. Nausea and vomiting with a localized form of the disease are observed in no more than 25% of patients.
In severe campylobacteriosis, diarrhea becomes profuse, which leads to dehydration. Violations of the water and electrolyte balance are especially dangerous for preschool children, causing them to have meningism, the development of convulsive syndrome.
With campylobacteriosis, diarrhea occurs with a frequency of bowel movements up to 15 times a day
Much less often, localized campylobacteriosis occurs in the form of appendicitis (catarrhal, phlegmonous) or acute mesenteric infection.
Generalized campylobacteriosis develops in people suffering from severe systemic diseases that weaken the immune system (HIV infection, cachexia, tuberculosis, malignant tumors, diabetes mellitus, etc.), as well as in children of the first year of life. The clinical picture of the disease includes:
- chills;
- profuse sweats;
- persistent increase in body temperature up to 40-41 ° С;
- dyspeptic symptoms;
- exhaustion;
- iron deficiency anemia;
- hepatosplenomegaly.
Generalized campylobacteriosis is accompanied by septicopyemia with the formation of metastatic purulent foci in various tissues and organs. Clinically, it can manifest itself as purulent arthritis, encephalitis, myocarditis, pleurisy, infective endocarditis.
The chronic form of campylobacteriosis is usually manifested by the following symptoms:
- unstable stools;
- prolonged subfebrile condition;
- decreased appetite;
- stomach ache;
- weight loss.
Very often, patients with chronic campylobacteriosis develop pharyngitis, keratitis, conjunctivitis. In women, this form of the disease can cause the development of recurrent vulvovaginitis, become a cause of spontaneous miscarriage.
Diagnostics
Campylobacteriosis can be suspected on the basis of a characteristic clinical picture and data from an epidemiological history (tourist trip, contact with farm animals).
When a colonoscopy or sigmoidoscopy is carried out at the height of the disease, signs of colitis or proctosigmoiditis are found. In feces, scatological examination reveals erythrocytes, leukocytes, mucus.
You can confirm the diagnosis of campylobacteriosis by the results of bacteriological examination of feces, blood, purulent contents of abscesses, and amniotic fluid. Serological diagnostic methods are also widely used.
Endoscopic intestinal biopsy may be needed to diagnose campylobacteriosis
In difficult diagnostic cases, an endoscopic intestinal biopsy is performed, followed by histological and bacteriological examination of the tissue obtained during the procedure.
Treatment
Therapeutic tactics for campylobacteriosis is determined by the severity and form of the disease. With a mild course of localized forms, antibiotic therapy is not prescribed. Oral rehydration with glucose-salt solutions is carried out, medical nutrition is prescribed (table No. 4 according to Pevzner). According to indications, biological bacterial preparations, enzymes, antispasmodics can be used.
With campylobacteriosis, therapeutic nutrition is indicated (diet No. 4 according to Pevzner)
With moderate and severe campylobacteriosis infection, antibiotic therapy is prescribed for a course of at least 10-14 days. With severe dehydration, saline and glucose solutions are injected intravenously.
Possible complications and consequences
The localized form of campylobacteriosis can be accompanied by the development of the following complications:
- intestinal bleeding;
- toxic megacolon;
- reactive arthritis;
- serous peritonitis.
Complications of the generalized form of campylobacteriosis include:
- infectious toxic shock;
- DIC syndrome;
- the formation of abscesses in the internal organs;
- infective endocarditis;
- multiple organ failure.
In the medical literature, there are indications of a relationship between Guillain-Barré syndrome and previous campylobacteriosis.
Forecast
With localized forms of campylobacteriosis, in most cases, complete recovery occurs within 7-10 days. Complications are rare and usually occur in individuals with an unfavorable concomitant background.
The prognosis for generalized forms of campylobacteriosis is always serious, the mortality rate reaches 30%.
Prevention
- Compliance with hygiene and food preparation rules.
- Measures to prevent infection of poultry and animals.
- Thorough sanitary control of food processing and storage technologies, water supply.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
