Campylobacter jejuni enteritis

　　Campylobacter jejuni enteritis is an acute intestinal infectious disease caused by Campylobacter jejuni, and its onset has the following reasons:

　　1. Source of infection

　　The source of infection is mainly animals. The genus Campylobacter is widely distributed in various animals, among which domestic poultry, wild birds, and domestic animals are most frequently infected, followed by rodents, in which Campylobacter is isolated.

　　2. Route of transmission

　　Fecal-oral is the main route of transmission.

　　3. Susceptibility

　　Humans are generally susceptible, and the incidence rate of children under 5 years old in developing countries is the highest, especially those under 1 year old, the incidence rate decreases with age, in developed countries and developing countries with better health conditions, the isolation rate of Campylobacter jejuni is highest in the age group of 10～29 years, indicating that the immunity of adults to the disease is not stronger than that of children.

　　It has been reported that Guillain-Barré syndrome often occurs after Campylobacter jejuni infection, and it is believed that Campylobacter jejuni infection is one of the causes of Guillain-Barré syndrome, and its pathogenesis may be related to immune response.

　　The incubation period of Campylobacter jejuni enteritis is 1～10 days, with an average of 5 days, and the incubation period of food poisoning type can be as short as 20 hours. In the early stage, there are prodromal symptoms such as headache, fever, and muscle pain, followed by diarrhea, nausea, and vomiting, with sudden onset of fever, abdominal pain, and diarrhea.

　　About 56.3～60% of fever patients are affected, usually with low to moderate fever, around 38℃, with some having high fever up to 40℃, accompanied by general malaise, and children with high fever may have convulsions. Abdominal pain and diarrhea are the most common symptoms, manifested as cramping colic in the entire abdomen or lower right abdomen, severe cases may resemble acute abdomen, but rebound pain is rare, diarrhea accounts for 91.9%. Generally, it starts as watery diarrhea, followed by mucus or purulent mucoid stool, some are obvious hematochezia, the number of diarrhea is usually 4～5 times, frequent cases can reach more than 20 times, when the lesion involves the rectum and sigmoid colon, there may be tenesmus, most of them recover within a week. Mild cases can recover within 24 hours, it is not easy to distinguish from viral gastroenteritis; 20% of patients have prolonged disease, intermittent diarrhea lasting for 2～3 weeks, or recurrence after recovery, or present as severe disease.

　　The most important source of infection for Campylobacter jejuni enteritis is animals, so it is crucial to control the infection of animals, prevent the contamination of water and food by animal excrement, and therefore, it is necessary to do a good job of the three controls, namely controlling water, feces, and food, which are powerful measures to prevent the spread of Campylobacteriosis. Currently, research is being conducted on attenuated live vaccines and heat-inactivated bacterial vaccines, which are expected to play an important role in eliminating the source of infection and preventing infection.

　　Patients with Campylobacter jejuni enteritis should undergo routine fecal examination, bacteriological examination, and serological examination.

　　1. Routine fecal examination

　　The appearance is mucus stool or loose watery stool, and the microscope examination shows a large number of white blood cells, or a large number of red blood cells.

　　2. Bacterial examination

　　Samples such as stool, intestinal swabs, or blood and puncture fluid from fever patients can be taken, and the culture is carried out in an anaerobic environment using selective culture media to isolate the bacteria. If the colonies have typical morphology and special biochemical characteristics, a diagnosis can be made.

　　3. Serological examination

　　Take two serum samples from the early and convalescent stages for indirect coagulation tests, and the antibody titer shows a 4-fold or more increase, which can be diagnosed.

　　Patients with Campylobacter jejuni enteritis are suitable for eating easily digestible semi-liquid food, and appropriate fluid replacement should be given if necessary.

　　1. Avoid smoking, drinking, and spicy stimulating foods, such as chili, horseradish, pepper, strong tea, coffee, cocoa, and other foods or drinks.

　　2. Pay attention to the balance of sugar, fat, and protein in food, and pay attention to the content of vitamins and other essential nutrients for the body.

　　3. Avoid unclean food: patients should pay special attention to dietary hygiene, especially in summer. Raw fruits and vegetables should be washed, and do not eat spoiled food. Foods stored in the refrigerator should be thoroughly cooked before eating. If spoilage is found, it should be discarded and not eaten.

　　4. Avoid cold, hot, and hard foods: such as cold or hot food and drinks.

　　5.Avoid eating raw garlic..

　　6. Avoid taking antidiarrheal drugs blindly.

　　7. Avoid eating high-fiber foods. Since intestinal inflammation cannot be stimulated, attention should be paid to diet.

　　Patients with Campylobacter jejuni enteritis should be isolated in the gastrointestinal tract, and the stool of the patient should be thoroughly disinfected. The isolation period starts from the onset of the disease to the negative stool culture. Symptomatic treatment should be given to patients with severe fever, abdominal pain, and diarrhea, and they should rest in bed. Easy-to-digest semi-liquid food should be provided for the diet, and appropriate fluid replacement should be given if necessary.

　　Campylobacter jejuni is sensitive to gentamicin, erythromycin, chloramphenicol, streptomycin, kanamycin, neomycin, tetracyclines, lincomycin, and resistant to penicillin and cephalosporins. Clinical treatment can be selected according to the condition. Enteritis can be treated with erythromycin, adults 0.8-1.2g/day, children 40-50mg/kg/day, taken orally, course of treatment 2-3 days. Quinolone antibacterial drugs, such as norfloxacin, are also effective, but they may affect the bone development of children. Gentamicin is the first choice for bacterial endocarditis. Chloramphenicol is the first choice for meningitis. The course of treatment for severe infections should be extended to 3-4 weeks to prevent recurrence.