S5068 Campylobacter Bacteremia: A Rare Complication of a Common GI Infection

Introduction: Campylobacter infections are typically confined to the gastrointestinal tract, manifesting commonly as abdominal pain and diarrhea. This slow-growing bacterium rarely extends beyond the gastrointestinal tract and thus sepsis due to Campylobacter species is very uncommon. Here we report a case of 63-year-old man with sepsis due to Campylobacter bacteremia. Case Description/Methods: A 63-year-old man presented with persistent abdominal pain, non-bloody diarrhea, and fever. Four days prior, he had been evaluated in emergency room for similar complains. His symptoms had started a few days after eating undercooked chicken at a barbecue party. The patient was admitted and treated with intravenous ceftriaxone, with some improvement in his diarrhea, and was discharged on cephalexin with pending blood cultures. On discharge home, his diarrhea and abdomen pain worsened and he presented the second time. While in the hospital, blood cultures from his earlier admission resulted positive for Campylobacter coli. His abdomen was tender in the right upper quadrant and epigastric region. Complete blood count and comprehensive metabolic panel were unremarkable. C-reactive protein was elevated. Abdomen computed tomography showed features suggestive of pancolitis. Stool culture was also positive for Campylobacter coli and negative for shigella toxin. He was treated with azithromycin which significantly improved his diarrhea and abdominal pain. Repeat blood cultures were negative. The patient was discharged home on oral azithromycin to complete a 14-day course with resolution of his sepsis. Discussion: Campylobacter is a known cause of enteroinvasive diarrhea; however, it is extremely uncommon to cause bacteremia. The most common clinical features associated with Campylobacter infection include abdominal pain and diarrhea, which is typically transient. The absence of specific clinical indicators for Campylobacter bacteremia, combined with resistance to commonly prescribed antibiotics, may contribute to delays in both identification and treatment. Furthermore, since blood cultures are not routinely obtained for patients presenting with acute gastrointestinal illnesses, this may lead to an underestimation of bacteremia related to Campylobacter. This particular case reminds us to consider Campylobacter as a potential pathogen in patients with classic gastrointestinal symptoms. Early identification and prompt initiation of appropriate antimicrobial therapy are crucial for achieving favorable clinical outcomes.