Is Campylobacter (a type of bacteria) diarrhea bloody?

Campylobacter Diarrhea and Blood in Stool

Yes, Campylobacter diarrhea is commonly bloody, with visible blood appearing in stools in a significant proportion of cases. 1

Clinical Presentation of Campylobacter Infection

Campylobacter infection typically presents with the following features:

• Bloody diarrhea: Campylobacter is specifically listed as one of the key pathogens associated with visible blood in stool 1
• Fever: Often present, though not as discriminatory for specific pathogens 1
• Abdominal pain: Particularly severe in Campylobacter infections and may even mimic appendicitis 2
• Duration: Typically self-limiting but can last several days to weeks

According to the Infectious Diseases Society of America's clinical practice guidelines, Campylobacter is one of the primary bacterial pathogens to consider when patients present with bloody diarrhea, along with STEC, Shigella, Salmonella, Entamoeba histolytica, noncholera Vibrio species, Yersinia, Balantidium coli, and Plesiomonas 1.

Epidemiology and Prevalence

Campylobacter is a common cause of bacterial diarrhea worldwide:

• It's frequently isolated from stool cultures of patients with diarrheal illness 3
• Infection rates tend to peak during summer and late fall 3
• All age groups can be affected, though young adults (20-34 years) show higher incidence 3

Pathophysiology

Campylobacter causes an invasive infection:

• The disease might be more accurately described as an enterocolitis rather than just enteritis, as both small intestine and colon are regularly involved 4
• The invasive nature of the infection explains the presence of blood in stools 4
• Sigmoidoscopy in infected patients often reveals proctitis with histological changes ranging from non-specific colitis to gross colitis with goblet-cell depletion and crypt-abscess formation 5

Clinical Studies on Bloody Diarrhea in Campylobacter

Research specifically examining clinical presentations has found:

• In one study of laboratory-confirmed Campylobacter jejuni cases, 9 out of 11 patients (82%) passed blood in their stools 5
• Another study found that patients with vomiting and/or bloody diarrhea tended to suffer a longer illness and were more likely to require hospital admission 6

Diagnostic Considerations

When evaluating patients with suspected Campylobacter infection:

• Stool cultures remain the gold standard for diagnosis
• Blood cultures should be obtained from patients with diarrhea and fever due to the high rate of bacteremia in some populations 1
• HIV-infected persons are at particular risk for infection with non-jejuni non-coli Campylobacter species, which require special culture conditions 1
• Newer molecular diagnostic panels can detect Campylobacter DNA but may not distinguish viable from non-viable organisms 1

Treatment Approach

For confirmed Campylobacter infections:

• Azithromycin is the preferred first-line antibiotic for severe Campylobacter jejuni diarrhea (1000 mg single dose or 500 mg daily for 3 days) 2
• Fluoroquinolones (ciprofloxacin, levofloxacin) may be used as alternatives only if local resistance patterns confirm susceptibility 2
• Supportive care with oral rehydration is essential 2

Complications and Monitoring

Important considerations for follow-up:

• Campylobacter infection has been associated with subsequent occurrence of Guillain–Barré syndrome 2
• Monitor for resolution of bloody diarrhea within 48-72 hours 2
• Watch for worsening symptoms, increased abdominal pain, fever, and dehydration 2

Prevention

Preventive measures include:

• Proper hand hygiene after potential contact with feces 1
• Avoiding raw or undercooked poultry, meat, and seafood 1
• Avoiding unpasteurized dairy products and fruit juices 1

In summary, bloody diarrhea is a common and characteristic feature of Campylobacter infection, reflecting the invasive nature of this bacterial pathogen in the intestinal mucosa.