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Campylobacter-associated enterocolitis in childhood. Report of a fatal case
Insights
Campylobacter fetus enterocolitis can mimic inflammatory bowel disease, even in chronically ill children. Prompt microbiologic re-examination is crucial for accurate diagnosis and treatment, as initial tests may be negative.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pediatric Pathology
Background:
- Inflammatory bowel disease (IBD) diagnosis can be challenging, particularly in pediatric cases with atypical presentations.
- Campylobacter fetus enterocolitis is an emerging cause of gastrointestinal illness with a wide clinical spectrum.
- Early diagnostic efforts for IBD may overlook infectious etiologies.
Observation:
- A chronically ill child presented with symptoms suggestive of inflammatory bowel disease.
- Initial diagnosis of Crohn's disease was based on radiographic findings after negative bacterial cultures.
- The patient's condition worsened despite immunosuppressive therapy.
Findings:
- Recurrent microbiologic examination revealed a heavy growth of Campylobacter fetus subspecies jejuni.
- The patient developed severe complications, including coagulopathy and widespread enterocolitis.
- The clinical course highlights the potential for Campylobacter fetus to cause severe enterocolitis mimicking IBD.
Implications:
- Campylobacter fetus should be considered in the differential diagnosis of pediatric inflammatory bowel disease, especially in refractory cases.
- Reconsideration of infectious etiologies, including Campylobacter, is vital when IBD treatment fails.
- This case underscores the importance of comprehensive microbiologic investigations in complex gastrointestinal disorders.
Abstract:
The full clinical range of Campylobacter fetus enterocolitis has become apparent only recently. This case study describes the clinical and pathologic findings in a chronically ill child who developed signs of inflammatory bowel disease. Following a negative bacteriologic culture, Crohn's disease was diagnosed by roentgenographic criteria. A trial of immunosuppressive therapy failed, and a repeat of microbiologic examination identified a heavy growth of Campylobacter fetus ss. jejuni. Various complications developed and the patient died with a coagulopathy and a widespread enterocolitis. The role of the Campylobacter in this clinical setting of inflammatory bowel disease is discussed in light of current understanding.