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Jejunal infection with Campylobacter.

T T Ward, K Klein, B K Borthistle

Archives of Internal Medicine

|May 1, 1984

Summary

Common variable immunodeficiency (CVI) patients with Campylobacter jejuni infection may present with prolonged diarrhea. Combination therapy with metronidazole and neomycin sulfate effectively eradicated the infection in this case.

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Area of Science:

Immunology
Infectious Diseases
Gastroenterology

Background:

Common variable immunodeficiency (CVI) is a primary immunodeficiency characterized by impaired antibody production.
Chronic malabsorption and opportunistic infections are common complications in CVI patients.
Campylobacter jejuni is a common cause of bacterial gastroenteritis.

Observation:

A CVI patient presented with chronic malabsorption and Campylobacter jejuni infection, diagnosed via jejunal aspiration.
The infection led to worsening diarrhea but lacked typical colitis symptoms.
Persistent C. jejuni shedding occurred despite initial antimicrobial treatments.

Findings:

Single-drug therapies (erythromycin ethylsuccinate, chloramphenicol) were ineffective and led to resistant C. jejuni strains.
Combination therapy with metronidazole and neomycin sulfate successfully cleared the persistent C. jejuni infection after five months.
Jejunal aspirate remained positive for C. jejuni while stool cultures were negative during the infection.

Implications:

C. jejuni infection in immunocompromised individuals can exhibit atypical clinical presentations and prolonged courses.
Antimicrobial resistance can emerge with monotherapy, necessitating combination treatment strategies.
This case highlights the importance of considering C. jejuni in CVI patients with unexplained chronic diarrhea and malabsorption.

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