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[Neurologic involvement in campylobacter infections. 5 cases]
P Clavelou1, J Beytout, A Gourdiat
1Clinique Neurologique, Hôpital Fontmaure, Chamalières.
Abstract:
Campylobacter are a newly recognized class of human infectious agents. Campylobacter fetus subspecies fetus is a cause of sepsis in immunocompromized hosts. Secondary neurological determinations, meningitis and meningoencephalitis appear to be rare. We report 2 cases, and 8 previously reported cases are reviewed. Campylobacter jejuni appears to be a common bacterial pathogen causing a syndrome of enteritis. Since 1982 it has been associated with Guillain-Barré syndrome (GBS). In one serological retrospective study, Campylobacter jejuni was the most common single pathogen identifiable in association with GBS, and these cases were significantly more severe. We report 3 cases with weakness and amyotrophy of distal limbs. Only 10 other cases have been found in the literature. Diarrhoea antedated the neurological illness by 4 to 21 days. In 4 syndromes of Miller-Fisher the prognosis was good. However electrophysiological axonal loss was reported in 6 GBS with poor functional prognosis. The pathogenic role of bacterial toxins and humoral immune response are discussed. Cross-reactivity between Campylobacter jejuni and human sciatic nerve proteins has not been demonstrated using sera from patients with GBS and serological evidence of Campylobacter enteritis.
Insights
Campylobacter fetus subspecies fetus can cause sepsis, and Campylobacter jejuni is linked to severe Guillain-Barré syndrome (GBS). Neurological complications from these bacteria, though rare, warrant further investigation into their pathogenesis.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Campylobacter fetus subspecies fetus is an emerging cause of sepsis, particularly in immunocompromised individuals.
- Campylobacter jejuni is a common cause of enteritis and has been associated with Guillain-Barré syndrome (GBS) since 1982.
Observation:
- Secondary neurological complications like meningitis and meningoencephalitis due to C. fetus subspecies fetus are rare, with only 10 previously reported cases and 2 new cases identified.
- Campylobacter jejuni is frequently identified in severe cases of Guillain-Barré syndrome (GBS), with reported cases presenting with distal limb weakness and amyotrophy.
- Miller-Fisher syndrome cases associated with Campylobacter jejuni showed good prognosis, while other GBS cases exhibited significant axonal loss and poor functional outcomes.
Findings:
- The study reviews rare neurological sequelae of Campylobacter infections, including meningitis, meningoencephalitis, and GBS.
- Campylobacter jejuni appears to be a significant trigger for severe Guillain-Barré syndrome, with enteritis preceding neurological symptoms.
- Electrophysiological studies indicate axonal loss in GBS cases with poor prognosis.
Implications:
- Understanding the pathogenic mechanisms, including bacterial toxins and immune responses, is crucial for managing Campylobacter-associated neurological disorders.
- Further research is needed to elucidate the cross-reactivity between Campylobacter jejuni and human neural proteins in GBS pathogenesis.
- These findings highlight the importance of considering Campylobacter species in the differential diagnosis of infectious and neurological conditions.