Campylobacter fetus bacteremia and meningitis in an acute lymphoblastic leukemia patient undergoing maintenance...

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Neurology

Background:

• Campylobacter fetus is an uncommon pathogen, primarily causing severe systemic infections like meningitis, endocarditis, and aortic aneurysms, unlike more common Campylobacter species that cause enteritis.
• Campylobacter fetus bacteremia is more prevalent than other Campylobacter species, detected in over half of infected patients.
• This case highlights the detection of C. fetus in both blood and cerebrospinal fluid (CSF) cultures.

Observation:

• A 33-year-old woman undergoing chemotherapy for acute lymphoblastic leukemia (ALL) presented with severe headache and nausea.
• Blood and CSF cultures confirmed the presence of Campylobacter fetus.
• The patient had no gastrointestinal symptoms, neck stiffness, or jolt accentuation, which are typical signs of meningitis.

Findings:

• Successful treatment of C. fetus meningitis was achieved using meropenem (2g IV every 8 hours for 3 weeks).
• The patient recovered without any neurological deficits.
• Undercooked beef was identified as the likely source of the C. fetus infection.

Implications:

• This case underscores the importance of considering C. fetus meningitis in immunocompromised patients, even with atypical presentations.
• Highlights the need for strict adherence to safe food handling practices and consideration of a neutropenic diet in immunocompromised individuals to prevent rare bacterial infections.
• Emphasizes the diagnostic utility of blood and CSF cultures for identifying C. fetus in serious systemic infections.