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Campylobacter enteritis in normal and immunodeficient children
Insights
Campylobacter fetus subspecies jejuni (CBJ) causes bacterial gastroenteritis in children. Immunodeficient children experience prolonged symptoms and pathogen excretion compared to healthy children.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Microbiology
Background:
- Campylobacter fetus subspecies jejuni (CBJ) is an emerging pathogen causing bacterial gastroenteritis in children.
- Gastroenteritis in children is often associated with bacterial pathogens.
- The role of CBJ in pediatric gastroenteritis is increasingly recognized.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of Campylobacter fetus subspecies jejuni gastroenteritis in children.
- To compare the disease course in immunodeficient versus immunologically normal children.
- To identify risk factors and specific host immune defects associated with severe CBJ infections.
Main Methods:
- Retrospective case series analysis of 51 children diagnosed with CBJ gastroenteritis over 16 months.
- Detailed clinical data collection including duration of fever, diarrhea, and pathogen shedding.
- Categorization of patients based on immune status (immunodeficient vs. normal).
Main Results:
- Five of 51 children diagnosed with CBJ gastroenteritis were immunodeficient, presenting with X-linked agammaglobulinemia, agammaglobulinemia, combined immunodeficiency, or transient hypogammaglobulinemia.
- Immunodeficient children exhibited significantly longer durations of fever (15 days) and diarrhea (23 days) compared to normal children (4 and 5 days, respectively).
- CBJ shedding in stool persisted longer in immunodeficient children (20-27 days, up to 1 year) than in normal children (4-16 days).
Conclusions:
- Campylobacter fetus subspecies jejuni is a significant bacterial pathogen in pediatric gastroenteritis, particularly affecting immunodeficient children.
- Humoral immune system defects are strongly associated with prolonged and severe CBJ infections in children.
- CBJ should be considered in the differential diagnosis of gastroenteritis in immunodeficient pediatric populations, especially those with hypogammaglobulinemia.
Abstract:
Campylobacter fetus subspecies jejuni (CBJ) has been recently recognized as a common pathogen in bacterial gastroenteritis in children. During a period of 16 months, 51 cases of C fetus subspecies jejuni gastroenteritis were diagnosed. Five of the children in whom the cases were diagnosed were previously known to be immunodeficient: two had X-linked agammaglobulinemia, one had agammaglobulinemia, one had combined immunodeficiency, and one had transient hypogammaglobulinemia. Average duration of fever and diarrhea was longer in the five immunodeficient children (15 and 23 days, respectively) compared with the normal children (four and five days, respectively). Excretion of C fetus subspecies jejuni in stool persisted for 20 to 27 days in four of the immunodeficient children and for one year in the fifth, whereas normal children excreted C fetus subspecies jejuni for only four to 16 days. Campylobacter fetus subspecies jejuni may be added to the list of bacterial pathogens most likely to infect immunodeficient children, especially those with a defect of the humoral system.