Persistent Campylobacter jejuni infection in an immunocompromised patient

Area of Science:

• Immunology
• Infectious Diseases
• Nephrology

Background:

• Campylobacter jejuni infections can cause severe illness, particularly in immunocompromised individuals.
• Patients undergoing hemodialysis and those with systemic lupus erythematosus (SLE) are at increased risk for infections.
• Immunoglobulin deficiencies can impair the host's ability to clear pathogens.

Observation:

• A patient with SLE on hemodialysis presented with recurrent bacteremia and enteritis caused by a specific serotype of Campylobacter jejuni over 12 months.
• The patient was noted to have deficiencies in serum immunoglobulin A (IgA) and immunoglobulin M (IgM).
• A defect in the patient's serum bactericidal activity against Campylobacter jejuni was identified.

Findings:

• The patient's IgA deficiency may have contributed to chronic gastrointestinal carriage of Campylobacter jejuni.
• Resolution of the bacteremia coincided with the emergence of delayed IgG antibodies specific to the infecting Campylobacter jejuni strain.
• These findings suggest a critical role for immunoglobulins in the host immune response against Campylobacter jejuni.

Implications:

• This case underscores the importance of assessing immunoglobulin levels in immunocompromised patients with recurrent infections.
• Understanding immunoglobulin function in fighting Campylobacter jejuni is crucial for developing targeted therapies.
• Further research into the interplay between host immune status and Campylobacter jejuni infections is warranted.