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Chapter: Modern Medical Toxicology: Food Poisons: Food Poisoning

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Campylobacter - Microbial Food Poisoning

The Campylobacter species responsible for food poisoning include C. jejuni, C. coli, and C. lari.

Campylobacter

While E. coli is the commonest cause of diarrhoea in Third World countries such as India, Campylobacter accounts for a significant number of cases, and rotavirus comes in at a close third. The Campylobacter species responsible for food poisoning include C. jejuni, C. coli, and C. lari.

Source

·              Undercooked meat products: chicken, beef, mutton, turkey, etc.

·              Unpasteurised milk and milk products.

·              Unchlorinated water.

Incubation Period

·              About 1 to 7 days.

Clinical Features

·              Like E. coli, Campylobacter is a common cause of “traveller’s diarrhoea”.

·      Watery or bloody diarrhoea.

·      Vomiting.

·      Abdominal pain.

·      Fever, malaise, headache.

·      The illness usually lasts for 5 to 6 days, but may sometimes persist for several weeks.

Complications

·              GI haemorrhage.

·              Haemolytic uraemic syndrome.

·              Meningitis.

·              Reactive arthritis.

·              Acute anterior uveitis.

·              Erythema nodosum.

·              Septicaemia (extremes of life, immunocompromised patients).

Diagnosis

■■   Microscopy of stool sample: Leukocytes are frequently seen. Phase contrast or dark field microscopy will reveal the characteristic darting or tumbling motility of the small, curved, rod-like bacteria in stained smears.

■■   Stool culture.

■■   Graded compression ultrasonography of the right lower abdominal region may show mural thickening of terminal ileum and caecum.

■■   Sigmoidoscopy: Oedematous, hyperaemic mucosa with shallow grey-based aphthous ulcers.

Treatment

■■   Rehydration.

■■   Erythromycin ethyl succinate, 400 mg, four times a day, decreases faecal shedding of the organism, but may not shorten the duration or severity of symptoms. Ciprofloxacin can also be used.

■■   Anticholinergics and opiates are contraindicated.

 

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