Campylobacter colitis presentin as inflammatory bowel disease with segmental colonic ulcerations

Campylobacter fetus subspecies have recently been recognized as an important cause of diarrheal illness in humans. We report a case of culture positive C. fetus colitis with colonoscopic findings of segmental mucosal edema, loss of normal vascular pattern with ulceration, and patchy involvement of mucosa. These colonoscopic findings were similar to those seen in granulomatous colitis. However, these findings may be difficult to distinguish from a number of other colonic mucosal diseases such as antibiotic-associated colitis, amebiasis, shigellosis, salmonellosis, invasive E. coli colitis, and ischemic colitis. On histopathologic examination of the mucosa, acute and chronic colitis with crypt abscess formation, mucosal atrophy, and mucous depletion was found which suggested the diagnosis of chronic ulcerative colitis. Cryptitis and crypt abscess are not specific to chronic ulcerative colitis alone and can be seen in many nongranulomatous inflammations of the colonic mucosa. Therapy with erythromycin led to prompt clinical improvement, clearance of the pathogen, and normalization of the colon by repeat examination 11 days after the initiation of the therapy.