Snapshot A 53-year-old woman presents to an urgent care clinic for diarrhea and abdominal cramping for the past 2 days. She reports having a subjective fever with nausea and frequent watery diarrhea that is occasionally bloody. She recently went on a backpacking trip throughout Southeast Asia and returned 5 days ago. On physical exam, she has dry mucous membranes and her abdomen is soft, nontender, and nondistended. She is started on intravenous hydration and a stool culture is sent. Given her recent travel history, she is started on appropriate antibiotics. Introduction Classification Campylobacter jejuni a comma/S-shaped, oxidase-positive gram-negative rod with a polar flagella grows at 42°C transmission via fecal-oral route causes watery or bloody diarrhea Epidemiology incidence the most common cause of bacterial diarrhea in the US demographics children > adults risk factors travel undercooked poultry or meat unpasteurized dairy products contact with infected domestic animals acid reflux medications (proton pump inhibitors) Pathogenesis invades gastrointestinal tract mucosa and disseminate Prognosis symptoms occur 1-3 days after exposure the disease is usually self-limited Presentation Symptoms fever abdominal cramps diarrhea can be watery or bloody with pus frequent stools nausea Physical exam weight loss signs of dehydration Studies Labs stool culture gold standard for diagnosis Making the diagnosis based on clinical presentation and laboratory studies Differential Enteroinvasive Escherichia coli (EIEC) infection distinguishing factor clinically very similar but presents more frequently with bloody diarrhea distinguish based on culture or polymerase chain reaction Treatment Management approach mainstay of treatment is supportive care as the disease is usually self-limited Conservative supportive care indication all patients modalities intravenous hydration electrolyte repletion Medical azithromycin indication severe infections or suspected traveler’s diarrhea, as the likelihood of a bacterial infection such as Campylobacter infection is high Complications Reactive arthritis (Reiter syndrome) classic triad of conjunctivitis, urethritis, and arthritis Guillain-Barre syndrome antigenic cross-reactivity between Campylobacter oligosaccharides and glycosphingolipids on neural tissues