CAMPYLOBACTEROSIS : CLINICAL ASPECTS
The illness typically begins 1 to 7 days after ingestion, with fever and lower abdominal pain that may be severe enough to mimic acute appendicitis. These are followed within hours by dysenteric stools that usually contain blood and pus. The illness is typically self-limiting after 3 to 5 days but may last 1 to 2 weeks. The diagnosis is confirmed by isola-tion of the organism from the stool. This requires a special medium made selective for Campylobacter by inclusion of antimicrobics that inhibit the normal facultative flora ofthe bowel. Plates must be incubated in a microaerophilic atmosphere that can now be conveniently generated in a sealed jar by hydration of commercial packs similar to those used for anaerobes.
Since less than half of patients clearly benefit from antimicrobial therapy, cases are usu-ally not treated unless the disease is severe or prolonged ( 1 week). C. jejuni is typically susceptible to macrolides and fluoroquinolones but resistant to β-lactams. Erythromycinis considered the treatment of choice but must be given early for maximal effect. Fluoro- quinolones are also effective, but resistance is becoming more common.