[Campylobacter jejuni infections in children]

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Campylobacter jejuni (C. j.) is a common cause of gastroenteritis in children.
• Abdominal pain, particularly in the right lower abdomen, is a frequent symptom, sometimes without diarrhea, mimicking appendicitis.
• Early identification of C. j. infections is crucial for appropriate management and preventing complications.

Purpose of the Study:

• To investigate the prevalence of Campylobacter jejuni (C. j.) in children presenting with gastroenteritis or acute abdominal symptoms, irrespective of diarrhea.
• To identify potential clinical or laboratory indicators for early diagnosis of C. j. infection in pediatric patients.
• To assess the antibiotic susceptibility of isolated C. j. strains, particularly to erythromycin.

Main Methods:

• A two-year prospective study involving the analysis of 974 fecal samples from children with gastroenteritis or acute abdominal symptoms.
• Fecal samples were tested for the presence of C. j., even in the absence of diarrhea.
• Clinical presentations, laboratory findings (including leucocytosis with left shift), and admission diagnoses were recorded.

Main Results:

• Campylobacter jejuni (C. j.) was isolated from 19 out of 974 fecal samples (2.0% prevalence).
• Suspicion of appendicitis was the most frequent admission diagnosis in children with gastroenteritis.
• Abdominal pain, often radiating to the right lower abdomen, was a prominent symptom, frequently occurring without diarrhea, especially in school-aged children. No specific laboratory parameters, apart from leucocytosis with left shift, aided early C. j. diagnosis.
• 16 out of 19 (84%) isolated C. j. strains demonstrated sensitivity to erythromycin.

Conclusions:

• Campylobacter jejuni (C. j.) can be an underlying cause of acute abdominal symptoms in children, even without diarrhea, and may be misdiagnosed as appendicitis.
• Current laboratory tests offer limited utility for the early diagnosis of C. j. infections in this pediatric population.
• Further controlled prospective studies are warranted to determine the efficacy of erythromycin in treating C. j. infections presenting with these clinical symptoms.