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Subtyping of Campylobacter jejuni ssp. doylei Isolates Using Mass Spectrometry-based PhyloProteomics MSPP
Published on: October 30, 2016
[Campylobacter jejuni meningitis]
E Skripkina1, A Canivet2, M Wautier3
1Service d'Anesthésie-Réanimation, CHU Liège, Belgique.
Abstract:
Cases of Campylobacter jejuni meningitis are extremely rare. In the literature, less than ten cases have been described so far, although Campylobacter spp is one of the most common pathogens causing gastroenteritis in the world. Some common stigmata can be found across these cases such as rupture of the blood-brain barrier, immunosuppression, as well as the tropism of Camplylobacter jejuni for neurological parenchyma. Campylobacter jejuni bacteremia is certainly underestimated because Campylobacter is a thermophilic bacterium and special conditions are required to isolate this organism in blood cultures. PCR is thus an interesting alternative technique for diagnosis. In our case, a patient with a history of resected astrocytoma, had undergone treatment with chemotherapy and radiotherapy because of anaplastic transformation. The patient was admitted with gastroenteritis and Campylobacter jejuni meningitis. The diagnosis was obtained initially on stool cultures and then by PCR of cerebrospinal fluid. The evolution was favorable with meropenem.
Insights
Campylobacter jejuni meningitis is rare, but this case highlights its potential in immunocompromised patients. Diagnosis was confirmed via stool culture and cerebrospinal fluid PCR, with successful treatment using meropenem.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Campylobacter jejuni is a common cause of gastroenteritis but rarely causes meningitis.
- Neurological complications of Campylobacter infections, including meningitis, are infrequently reported.
- Factors like blood-brain barrier disruption and immunosuppression may predispose individuals to Campylobacter meningitis.
Observation:
- A patient with a history of astrocytoma treated with chemotherapy and radiotherapy presented with gastroenteritis and meningitis.
- Initial diagnosis was confirmed by stool cultures.
- Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) provided a definitive diagnosis of C. jejuni meningitis.
Findings:
- Campylobacter jejuni bacteremia may be underdiagnosed due to the bacterium's thermophilic nature and specific culture requirements.
- PCR is a sensitive and effective diagnostic tool for C. jejuni meningitis, particularly when blood cultures are negative or difficult to obtain.
- The patient experienced a favorable outcome with meropenem treatment.
Implications:
- This case highlights the importance of considering C. jejuni as a potential cause of meningitis in immunocompromised individuals.
- Enhanced diagnostic strategies, including PCR, are crucial for timely identification and management of rare C. jejuni infections.
- Further research is warranted to understand the pathogenesis and optimize treatment protocols for C. jejuni meningitis.
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