Which statement is true about Campylobacter infection?

Campylobacter Infection: Key Facts

The incubation period of Campylobacter infection can be up to 10 days, which is TRUE among the given options. 1

Epidemiology and Transmission

Campylobacter jejuni is one of the most common causes of bacterial gastroenteritis worldwide. The primary mode of transmission is:

• Foodborne transmission, particularly from:

  • Undercooked poultry and poultry products 2
  • Raw or unpasteurized milk 3
  • Contaminated shellfish 3

• NOT primarily from contaminated water (although waterborne outbreaks can occur)

• The incubation period ranges from 1-10 days, with most cases developing symptoms 2-5 days after exposure 1

Clinical Presentation

Campylobacter infection typically presents with:

• Fever (53-83% of cases) 1
• Abdominal pain (84-92% of cases) - often severe and may mimic appendicitis 1
• Diarrhea - may be bloody in 21-97% of cases 1
• Nausea and vomiting (37-49% of cases) 1

Diagnosis

• Stool examination for leukocytes is NOT the most reliable method of diagnosis (only positive in 25-80% of cases) 1
• Preferred diagnostic methods include:
  • Stool culture (gold standard)
  • PCR-based methods
  • Antigen detection tests

Pathology

• Campylobacter infection does NOT typically cause distortion of colonic crypt architecture, which is more characteristic of chronic inflammatory bowel diseases 1
• Acute inflammation with neutrophilic infiltrates is the predominant histopathological finding

Treatment

• Cephalosporins are NOT effective in treating Campylobacter infections 1

• First-line treatment options include:

  • Azithromycin (500 mg daily IV/PO) is the drug of choice due to increasing fluoroquinolone resistance 1
  • Fluoroquinolones (e.g., ciprofloxacin) may be used as alternatives but resistance rates are increasing (up to 19%) 1

• Treatment considerations:

  • Most cases are self-limiting and may not require antibiotics
  • Antibiotic therapy shortens illness duration by approximately 1 day 1
  • Treatment is particularly recommended for:
    • Severe disease
    • Prolonged symptoms
    • Immunocompromised patients 1

Prevention

• Proper food handling and cooking practices
• Avoiding consumption of raw or undercooked poultry
• Pasteurization of milk
• Proper handwashing after contact with animals or raw meat

Complications

• Post-infectious irritable bowel syndrome
• Guillain-Barré syndrome
• Reactive arthritis

The key point to remember is that Campylobacter infection has an incubation period that can extend up to 10 days, which is longer than many other common foodborne pathogens.