Multidrug-Resistant Campylobacter jejuni Bacteremia Case Following Sheepskin Wrap Application

Campylobacter jejuni typically causes gastrointestinal illness but may lead to severe systemic infection in immunocompromised hosts. Resistance to macrolides, fluoroquinolones, and tetracyclines is increasingly reported.

A 27-year-old male with X-linked agammaglobulinemia developed recurrent right foot cellulitis after local trauma. Following application of a non-sterile herbal ointment and sheepskin, the lesion progressed, and the patient developed fever and chills. Blood cultures repeatedly yielded multidrug-resistant C. jejuni, while wound culture grew Citrobacter braakii. The C. jejuni isolates showed high MICs to macrolides, fluoroquinolones, and tetracycline. Given persistent bacteremia despite broad-spectrum therapy, meropenem was initiated, resulting in rapid defervescence and clinical improvement.

This case highlights the potential for transdermal acquisition of C. jejuni in immunodeficient patients, the clinical challenges posed by multidrug-resistant strains, and the need for education regarding traditional practices that may increase infection risk.