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Kirk KF, Boel J, Nielsen HL. Vertebral osteomyelitis caused by Campylobacter jejuni in an immunocompetent patient. Gut Pathog 2023; 15:61. [PMID: 38037181 PMCID: PMC10688457 DOI: 10.1186/s13099-023-00589-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Campylobacter jejuni is the leading cause of human bacterial gastroenteritis worldwide. However, systemic infection with C. jejuni is uncommon, and osteomyelitis caused by C. jejuni is extremely rare. Cultivation from spinal bone biopsies has not previously been reported in the literature. CASE PRESENTATION A 79-year-old immunocompetent male was admitted to the emergency department at Aalborg University Hospital in Denmark with lower back pain, fever and diarrhoea. A FecalSwab obtained upon admission was PCR-positive for Campylobacter spp, while an aerobic blood culture bottle was positive for C. jejuni (Time to detection: 70.4 h). A MRI of columna totalis showed osteomyelitis at L1/L2 with an epidural abscess from L1 to L2 with compression of the dura sack. The patient underwent spinal surgery with spondylodesis and decompression of L1/L2. The surgery was uncomplicated and the discus material was also culture positive for C. jejuni. The patient was treated with meropenem for a total duration of four weeks, followed by four weeks of oral treatment with clindamycin in tapered dosage. The patient recovered quickly following surgery and targeted antibiotic treatment with decreasing lumbar pain and biochemical response and was fully recovered at follow-up three months after end of treatment. CONCLUSIONS While C. jejuni osteomyelitis is rare, it should still be suspected as a possible causative bacterial aetiology in patients with vertebral osteomyelitis, in particular when symptoms of diarrhoea is involved in the clinical presentation. Susceptibility testing is crucial due to emerging resistance, and targeted treatment strategies should rely upon such tests.
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Affiliation(s)
- Karina Frahm Kirk
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, 9000, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jeppe Boel
- Department for Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Hans Linde Nielsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
- Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18, Aalborg, 9000, Denmark.
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2
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Cervical osteomyelitis potentially caused by Campylobacter fetus. J Infect Public Health 2021; 14:1233-1236. [PMID: 34454173 DOI: 10.1016/j.jiph.2021.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 08/09/2021] [Accepted: 08/15/2021] [Indexed: 11/24/2022] Open
Abstract
Campylobacter fetus is a rare pathogen in humans. It mainly causes invasive infections in immunosuppressed patients. Herein, we report the first case of cervical vertebral osteomyelitis in a previously healthy man with a history of daily alcohol consumption. Treatment was given for six weeks with excellent clinical recovery and normalization of laboratory markers.
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3
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Ikeda K, Manabe Y, Fujiwara S, Omote Y, Narai H, Abe K. Campylobacter fetus Meningitis and Pyogenic Spondylodiscitis in a Healthy Young Woman. Case Rep Neurol 2019; 11:299-303. [PMID: 31824284 DOI: 10.1159/000503814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/29/2019] [Indexed: 11/19/2022] Open
Abstract
We report a rare case of Campylobacter fetus meningitis and pyogenic spondylodiscitis in a healthy young woman. A 35-year-old woman without significant medical history presented with fever, headache, and low back pain. C. fetus was detected from the blood culture. Cerebrospinal fluid analysis showed bacterial meningitis 2 days after onset. Although initial magnetic resonance imaging (MRI) did not reveal abnormal findings, repeated MRI showed a low-signal-intensity lesion on T1-weighted image (T1WI) and a high-signal-intensity lesion on T2WI between the L5 and S1 vertebral bodies 11 days after onset. The mode of infection was considered to be the consumption of raw chicken meat. After antibiotic treatment with 12 g/day ampicillin following 6 g/day meropenem, she was discharged 51 days after onset. As the inflammatory signs on MRI improved, oral antibiotic therapy was discontinued 85 days after onset. Although the initial MRI showed no abnormal findings, repeat MRI should be performed for patients who have persistent low back pain and fever.
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Affiliation(s)
- Kenta Ikeda
- Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yasuhiro Manabe
- Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shunya Fujiwara
- Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yoshio Omote
- Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Hisashi Narai
- Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan
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4
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Olaiya D, Fok R, Chakrabarti P, Sharma H, Greig J. Campylobacter fetus spondylodiscitis: A case report and review of the literature. IDCases 2018; 14:e00468. [PMID: 30479962 PMCID: PMC6251783 DOI: 10.1016/j.idcr.2018.e00468] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 11/24/2022] Open
Abstract
Campylobacter are common zoonotic food borne pathogens but infrequent causes of disseminated human infection. Campylobacter fetus is an unusual cause of human infection and spondylodiscitis. We describe a case of C. fetus infection in a 72-year-old woman who presented with indolent onset lumbar spondylodiscitis. The literature is reviewed and the presentation of spondylodiscitis is contrasted with the usual aggressive nature of bacteremia with this pathogen.
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Affiliation(s)
- Daniel Olaiya
- Department of Neurosurgery, University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth PL6 8DH, UK
| | - Rosemary Fok
- Department of Microbiology, University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth PL6 8DH, UK
| | - Prithwiraj Chakrabarti
- Department of Microbiology, Royal Cornwall Hospital NHS Trust, Treliske, Truro TR1 3LQ, UK
| | - Himanshu Sharma
- Department of Neurosurgery, University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth PL6 8DH, UK
| | - James Greig
- Department of Microbiology, University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth PL6 8DH, UK
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5
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Laenens D, Plazier M, van der Hilst JCH, Messiaen P. Campylobacter fetus spondylodiscitis in a patient with HIV infection and restored CD4 count. BMJ Case Rep 2018; 2018:bcr-2018-225272. [PMID: 30012680 DOI: 10.1136/bcr-2018-225272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Campylobacter fetus (C. fetus) is a rare condition and mostly seen in elderly or immunocompromised patients. We present the first case of C. fetus spondylodiscitis in a virologically suppressed HIV seropositive patient with low back pain. MRI was performed and showed spondylodiscitis of the L4-L5 region. Empirical antibiotic therapy with flucloxacillin was started after blood cultures were drawn and an image-guided disc biopsy was performed. Blood cultures remained negative. The anaerobic culture of the puncture biopsy of the disc revealed presence of C. fetus after which the antibiotic treatment was switched to ceftriaxone. Guided by the susceptibility results, the therapy was switched to ciprofloxacin orally for 6 weeks after which the patient made full clinical, biochemical and radiographic recovery. Since no other immune-deficient conditions were noted, it is important to highlight that patients with HIV infection with restored CD4 counts and complete virological suppression can still be susceptible for infections caused by rare pathogens. Low back pain should raise suspicion for these conditions and should be examined properly.
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Affiliation(s)
- Dorien Laenens
- Department of Infectious Diseases and Immunity, Jessa Ziekenhuis vwz, Hasselt, Belgium
| | - Mark Plazier
- Department of Neurosurgery, Jessa Ziekenhuis vwz, Hasselt, Belgium.,Department of Morphology, Faculty of Medicine and Health Sciences, Universiteit Hasselt, Hasselt, Belgium
| | - Jeroen C H van der Hilst
- Department of Infectious Diseases and Immunity, Jessa Ziekenhuis vwz, Hasselt, Belgium.,BIOMED Research Institute, Universiteit Hasselt, Hasselt, Belgium
| | - Peter Messiaen
- Department of Infectious Diseases and Immunity, Jessa Ziekenhuis vwz, Hasselt, Belgium.,BIOMED Research Institute, Universiteit Hasselt, Hasselt, Belgium
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6
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Choi HS, Shin SU, Bae EH, Ma SK, Kim SW. Infectious Spondylitis in a Patient with Chronic Kidney Disease: Identification of Campylobacter fetus Subsp. testudinum by 16S Ribosomal RNA Sequencing. Jpn J Infect Dis 2016; 69:517-519. [DOI: 10.7883/yoken.jjid.2015.461] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School
| | - Sung Un Shin
- Department of Internal Medicine, Chonnam National University Medical School
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School
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7
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Prendki V, Marmor S, Zeller V, Lhotellier L, Mégraud F, Desplaces N. Campylobacter infection after prosthetic joint surgery. ACTA ACUST UNITED AC 2013; 45:706-10. [PMID: 23808718 DOI: 10.3109/00365548.2013.800225] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Few cases of Campylobacter prosthetic joint infection (PJI) have been reported so far. We describe the demographic characteristics, underlying conditions, clinical features, treatment, and outcome of 8 patients with Campylobacter PJI in our hospital. All strains were confirmed at the French National Reference Center for Campylobacter and Helicobacter. Seven patients were infected with C. fetus and 1 with C. jejuni. Most patients were elderly and immunocompromised. Four had bacteremia, one of these with a pacemaker endocarditis. All the patients received at least 3 months of antibiotic treatment and 6 were treated surgically. The outcome was favorable at 2 years of follow-up in all except for 1 patient. Campylobacter PJI cases are rare but likely to become more frequent. C. fetus bacteremia should motivate physicians to look for a secondary localization such as a Campylobacter PJI.
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Affiliation(s)
- Virginie Prendki
- Service d'Orthopédie, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France.
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8
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A Case of Pyogenic Spondylodiscitis Caused by Campylobacter fetus for Which Early Diagnosis by Magnetic Resonance Imaging Was Difficult. Asian Spine J 2012; 6:274-8. [PMID: 23275811 PMCID: PMC3530702 DOI: 10.4184/asj.2012.6.4.274] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 07/29/2011] [Accepted: 08/11/2011] [Indexed: 11/26/2022] Open
Abstract
The purpose of this case report was to report a rare case of pyogenic spondylodiscitis caused by Campylobacter fetus. A 37-year-old male presented with fever and low back pain. By lumbar magnetic resonance imaging (MRI), no abnormal finding was observed at the first presentation. However, low back pain was aggravated, and fever did not improve. Thus, lumbar MRI was repeated on the 26 day after the onset of symptoms, showing abnormal signals at vertebrae and disc spaces, and pyogenic spondylitis was diagnosed. The possibility of pyogenic spondylodiscitis should be taken into account if a patient presents with low back pain and fever, and areas of low signal intensity on a T1-weighted MRI should be carefully examined. When initial MRI does not reveal abnormal findings, repeated MRI after one or two weeks or, more favorably, immediate gadolinium enhancement MRI, are important for patients who have persistent low back pain and fever.
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9
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Molecular detection of Campylobacter jejuni as a cause of culture-negative spondylodiscitis. J Clin Microbiol 2012; 50:1499-500. [PMID: 22259199 DOI: 10.1128/jcm.06275-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Spondylodiscitis caused by Campylobacter species is a rare disease which is most often caused by Campylobacter fetus. We report a case of culture-negative spondylodiscitis and a psoas abscess due to Campylobacter jejuni in a 68-year-old woman, as revealed by 16S rRNA gene and Campylobacter-specific PCRs from biopsied tissue.
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10
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Abstract
A growing number of Campylobacter species other than C. jejuni and C. coli have been recognized as emerging human and animal pathogens. Although C. jejuni continues to be the leading cause of bacterial gastroenteritis in humans worldwide, advances in molecular biology and development of innovative culture methodologies have led to the detection and isolation of a range of under-recognized and nutritionally fastidious Campylobacter spp., including C. concisus, C. upsaliensis and C. ureolyticus. These emerging Campylobacter spp. have been associated with a range of gastrointestinal diseases, particularly gastroenteritis, IBD and periodontitis. In some instances, infection of the gastrointestinal tract by these bacteria can progress to life-threatening extragastrointestinal diseases. Studies have shown that several emerging Campylobacter spp. have the ability to attach to and invade human intestinal epithelial cells and macrophages, damage intestinal barrier integrity, secrete toxins and strategically evade host immune responses. Members of the Campylobacter genus naturally colonize a wide range of hosts (including pets, farm animals and wild animals) and are frequently found in contaminated food products, which indicates that these bacteria are at risk of zoonotic transmission to humans. This Review presents the latest information on the role and clinical importance of emerging Campylobacter spp. in gastrointestinal health and disease.
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Affiliation(s)
- Si Ming Man
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
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11
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Chaillon A, Baty G, Lauvin MA, Besnier JM, Goudeau A, Lanotte P. Campylobacter fetus subspecies fetus spondylodiscitis. J Med Microbiol 2010; 59:1505-1508. [PMID: 20705728 DOI: 10.1099/jmm.0.023382-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Campylobacter spp. are common causes of gastrointestinal infections. Campylobacter fetus is a much rarer pathogen in humans, and usually causes bacteraemia and systemic complications in patients with predisposing conditions. We report a case of spondylodiscitis caused by C. fetus subsp. fetus as revealed by vertebral biopsy culture. This identification was confirmed by sequencing the 16S rRNA gene and by phylogenetic analysis. Treatment consisted of 6 weeks antimicrobial therapy combined with a strict initial immobilization, followed by a re-education program. The patient's recovery was uneventful.
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Affiliation(s)
- Antoine Chaillon
- Université François-Rabelais de Tours, UFR Médecine, 2 Bis Boulevard Tonnellé, 37032 Tours Cedex, France.,Service de Bactériologie-Virologie, CHRU Bretonneau, 37044 Tours Cedex 9, France
| | - Gaelle Baty
- Service de Bactériologie-Virologie, CHRU Bretonneau, 37044 Tours Cedex 9, France
| | - Marie Agnès Lauvin
- Groupement d'Imagerie Médicale, CHRU Bretonneau, 37044 Tours Cedex 9, France
| | - Jean Marc Besnier
- Service de Médecine Interne et Maladies Infectieuses, CHRU Bretonneau, 37044 Tours Cedex 9, France.,Université François-Rabelais de Tours, UFR Médecine, 2 Bis Boulevard Tonnellé, 37032 Tours Cedex, France
| | - Alain Goudeau
- Université François-Rabelais de Tours, UFR Médecine, 2 Bis Boulevard Tonnellé, 37032 Tours Cedex, France.,Service de Bactériologie-Virologie, CHRU Bretonneau, 37044 Tours Cedex 9, France
| | - Philippe Lanotte
- Université François-Rabelais de Tours, UFR Médecine, 2 Bis Boulevard Tonnellé, 37032 Tours Cedex, France.,Service de Bactériologie-Virologie, CHRU Bretonneau, 37044 Tours Cedex 9, France
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12
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Abstract
Campylobacter fetus has been isolated as an infrequent cause of abscesses. We report a case of Campylobacter fetus epidural abscess and bacteremia in a debilitated elderly man who had a fatal outcome.
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13
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de Vries JJC, Arents NLA, Manson WL. Campylobacter species isolated from extra-oro-intestinal abscesses: a report of four cases and literature review. Eur J Clin Microbiol Infect Dis 2008; 27:1119-23. [PMID: 18488257 DOI: 10.1007/s10096-008-0550-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 04/28/2008] [Indexed: 12/12/2022]
Abstract
Campylobacter species are frequently isolated from fecal specimens of patients with diarrheal illness. Several Campylobacter species are commonly isolated from the oral cavity. In contrast, Campylobacter species are rarely isolated from extra-oro-intestinal abscesses. Reported here are four cases of extra-oro-intestinal abscesses due to polymicrobial flora, including Campylobacter species. The first case is a 35-year-old woman who was diagnosed with a brain abscess caused by C. gracilis, Streptococcus constellatus, and anaerobic Gram-positive cocci. The second case is a 65-year-old man with a history of maxillary sinus carcinoma who developed a brain abscess due to polymicrobial flora, including C. concisus. The third case is a 24-year-old male who was diagnosed with a vertebral abscess caused by C. rectus, Eubacterium brachy, and Actinomyces species. The fourth case is a 74-year-old woman who presented with an intraorbital abscess due to C. showae and Micromonas (previously Peptostreptococcus) micros. The first two patients died from a cause directly related to their abscesses. All Campylobacter species involved in the four cases were isolated anaerobically. The isolation of oral Campylobacter species, e.g., C. rectus and C. showae, from abscesses suggests an oral source. A survey of the English literature was undertaken to identify reports of Campylobacter species isolated from extra-oro-intestinal abscesses.
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Affiliation(s)
- J J C de Vries
- Department of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands.
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14
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Zonios DI, Panayiotakopoulos GD, Kabletsas EO, Tzima EL, Stefanou I, Archimandritis AJ. Campylobacter fetus bacteraemia in a healthy individual: clinical and therapeutical implications. J Infect 2006; 51:329-32. [PMID: 16291287 DOI: 10.1016/j.jinf.2004.08.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2004] [Indexed: 11/26/2022]
Abstract
Campylobacter species are well-recognized common causes of gastrointestinal infections. While Campylobacter jejuni is probably the most common Campylobacter isolated in humans, Campylobacter fetus is rather infrequent and mostly related with bacteraemia. Even on such occasions, it seems that immunocompetent individuals are spared. We report a case of C. fetus bacteraemia in a healthy-except for impaired fasting glucose (IFG) levels-farmer, presenting as an acute febrile syndrome and treated successfully as brucellosis.
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Affiliation(s)
- Dimitrios I Zonios
- Department of Pathophysiology, Medical School, University of Athens, 75 Mikras Asias Street, Athens 115 27, Greece.
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Casadémont I, Bizet C, Chevrier D, Guesdon JL. Rapid detection of Campylobacter fetus by polymerase chain reaction combined with non-radioactive hybridization using an oligonucleotide covalently bound to microwells. Mol Cell Probes 2000; 14:233-40. [PMID: 10970727 DOI: 10.1006/mcpr.2000.0312] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Campylobacter fetus is recognized as a human and animal pathogen. The isolation and differentiation of C. fetus in diagnostic laboratories is hindered by its relatively slow growth and lack of distinguishing biochemical characteristics. We cloned and sequenced a 1581-bp DNA fragment, IG02, isolated from a C. fetus genomic library. This fragment was used as a probe on DNAs extracted from C. fetus strains and other Campylobacter species: IG02 hybridized only with DNAs from C. fetus strains. A PCR-based test was developed for the detection of C. fetus. A pair of oligonucleotide primers was designed to amplify a 141-bp fragment of IG02. The amplified product was analysed by a non-radioactive sandwich hybridization in microtiter plate using a capture oligonucleotide and a biotin-labelled oligonucleotide for the detection. The combination of PCR and non-radioactive microplate hybridization is a convenient method for the rapid detection of C. fetus.
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Affiliation(s)
- I Casadémont
- Laboratoire de Prédéveloppement des Sondes, Institut Pasteur, Paris, Cedex 15, 75724, France
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