Cause:Campylobacter jejuni
Contaminated water, surface water, and municipal water supplies (Ann IM 1982;96:293); similar epidemiology to giardia. Also may be sporadic, foodborne, often by eggs. Cattle, goats, horses, and perhaps wild animals excrete in feces. 3× more frequent than giardia; more common than salmonella and shigella (Harvard Medical School CME lecture 3/85)
Chronic colitis; Guillain-Barré syndrome (Nejm 1995;333:1374); immunoproliferative small bowel disease (alpha chain disease), a mucosa-associated lymphoid tissue (MALT) lymphoma w plasma cell infiltration of bowel wall and monoclonal -heavy chain, prevalent around Mediterranean, causes a chronic wasting diarrhea, can cause diffuse B-cell lymphomas and is rx'd w combinations of antibiotics like amoxicilin + clarithromycin + metronidazole
r/o ulcerative colitis relapses
Rx:Caution using erythromycin if sx >3 d bcs widespread resistance internationally; ciprofloxacin (Arch IM 1990;150:541), or other quinolone (azithromycin 1 gm once); drug resistance appearing because of antibiotic use in poultry industry (Nejm 1999;340:1525)