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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.
· Undercooked meat products: chicken, beef, mutton, turkey, etc.
· Unpasteurised milk and milk products.
· Unchlorinated water.
· About 1 to 7 days.
· Like E. coli, Campylobacter is a common cause of “traveller’s diarrhoea”.
· Watery or bloody diarrhoea.
· Abdominal pain.
· Fever, malaise, headache.
· The illness usually lasts for 5 to 6 days, but may sometimes persist for several weeks.
· GI haemorrhage.
· Haemolytic uraemic syndrome.
· Reactive arthritis.
· Acute anterior uveitis.
· Erythema nodosum.
· Septicaemia (extremes of life, immunocompromised patients).
■■ 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.
■■ 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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