Lethal maternal sepsis caused by Campylobacter jejuni: pathogen preserved in placenta and identified by molecular...

Campylobacter jejuni is one of the most common organisms in the etiology of febrile diarrhea. Bacteremia is reported to be rare. In pregnant women, however, C. jejuni (previous name, Vibrio fetus) can cause fetal death. We report the case of a pregnant woman with enterocolitis and sepsis that caused the death of the fetus and, 11 days later, the death of the mother. C. jejuni was detected by culture techniques at the time of the first symptoms but not during the subsequent course of disease. Bacteria were detected by silver staining and electron microscopic examination in the placenta, but for identification, we used molecular methods. From formalin-fixed, paraffin-embedded placental tissues, a part of the bacterial 16S rRNA was amplified by broad-range polymerase chain reaction, which resulted in a 461-nucleotide sequence. Direct sequencing and comparison to reference sequences revealed C. jejuni as the causative agent for the sepsis and deaths. With this approach, the adverse outcome could be related etiologically to the same infectious agent identified at the onset of the disease. From this and other recent reports, we conclude that C. jejuni must be considered an important pathogen in pregnancy.