Campylobacter jejuni enteritis
Introduction
Introduction to Campylobacter jejuni Campylobacter jejunienteritis is an acute intestinal infectious disease caused by Campylobacter jejuni. Clinically, it is characterized by fever, abdominal pain, bloody stools, and more neutrophils and red blood cells in the feces. The most important source of infection for jejunal flexion disease is animals. How to control animal infections and prevent animal waste from polluting water and food is essential. Therefore, it is a powerful measure to prevent the spread of Campylobacter disease by doing three tubes, that is, tube water, tube dung, and tube food. At present, research on live attenuated vaccines and heat-killing bacteria are expected to play an important role in eliminating infection sources and preventing infection. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: digestive tract spread Complications: Campylobacter infection
Cause
Cause of Campylobacter jejuni enteritis
(1) Source of infection
Mainly animals, Campylobacter is widely distributed in various animals, among which poultry, wild birds and livestock are the most carriers, followed by Campylobacter.
(2) Ways of transmission
A dung is the main route of transmission.
(3) Susceptibility
People are generally susceptible. The incidence of children under 5 years old is the highest in developing countries, especially those under 1 year old. The incidence rate decreases with age. In developed countries with better sanitary conditions in developed countries, the isolation rate of Campylobacter jejuni is 10 The age of 29 years old is the highest, indicating that adults are not more immune to the disease than children.
Prevention
Campylobacter jejuni prevention
The most important source of infection for jejunal flexion disease is animals. How to control animal infections and prevent animal excreta from polluting water. Food is vital. Therefore, three tubes are used to control water, tube dung, and tube food to prevent the spread of Campylobacter. The effective measures are currently studying attenuated live vaccines and heat-killing bacteria, which are expected to play an important role in eliminating infection sources and preventing infections.
Complication
Complications of Campylobacter jejuni enteritis Complications Campylobacter infection
It has been reported that Guillain-Barri syndrome often occurs after the infection of Campylobacter jejuni, which is considered to be one of the causes of GB. The pathogenesis may be related to the immune response. 1 The sphingomyelin of bacteria and nerve fibers have a generic antigen, which can be cross-immunized. 2 enterotoxin binds to gangliosides; 3 cells mediate immune damage.
Symptom
C. jejuni enteritis symptoms Common symptoms Fever accompanied by abdominal pain, ... Muscle soreness, nausea, convulsions, high fever, abdominal pain, diarrhea, urgency, acute abdomen
The incubation period is 1 to 10 days, with an average of 5 days. The food poisoning type incubation period can be only 20 hours.
Initially there are headaches, fever, muscle soreness and other prodromal symptoms, followed by diarrhea, nausea and vomiting, sudden onset of fever, abdominal pain and diarrhea.
Fever accounts for about 56.3 to 60%, usually low to moderate fever, body temperature of about 38 ° C, individual high fever up to 40 ° C, accompanied by general malaise, children with high fever can be accompanied by convulsions.
Abdominal pain and diarrhea are the most common symptoms, which are characterized by cramps in the whole abdomen or lower right abdomen. The drama is like acute abdomen, but rare rebound tenderness. The diarrhea accounts for 91.9%. It is usually watery and thin, followed by mucus or pus. Blood mucus, some for obvious bloody stools, the number of diarrhea, mostly 4 to 5 times, the frequency can reach more than 20 times, the lesion involving the rectum, sigmoid colon, can be urgency and heavy, most self-healing within 1 week, light for 24 hours Healing is not easy to distinguish from viral gastroenteritis; 20% of patients have prolonged disease, intermittent diarrhea lasts for 2 to 3 weeks, or relapses or is severe.
Examine
Examination of Campylobacter jejuni enteritis
Stool routine
Appearance is mucus or water, microscopic examination has more white blood cells, or more red blood cells.
2. Bacteriology examination
It is advisable to take the patient's stool, intestinal swab, or fever patient's blood, puncture fluid, etc. as a sample, use selective medium, culture under anaerobic environment, and isolate the pathogen. If it has typical colony morphology and special biochemical characteristics, it can be diagnosed. .
3. Serological examination
Take the early and recovery period of the double serum for indirect coagulation test, the antibody titer is increased by 4 times or more, and the diagnosis can be confirmed.
Diagnosis
Diagnosis and diagnosis of Campylobacter jejuni
Diagnostic criteria
Infantile Campylobacter enteritis is more atypical, manifested as: 1 systemic symptoms are mild, mental and appearance are not disease-free; 2 most have no fever and abdominal pain; 3 only intermittent mild diarrhea, between bloody stools, lasting longer; 4 minority Stunted due to diarrhea.
Differential diagnosis
(1) Bacterial dysentery
Typical sputum has high fever, abdominal pain, diarrhea, diarrhea and pus and blood, abdominal pain in the lower abdomen or left lower abdomen, left lower abdomen is obviously tender, and there are intestinal cords, accompanied by obvious urgency and heavy, fecal examination has more pus cells, phagocytic cells, severe dehydration, This is good for distinguishing from this disease.
(2) Diarrhea caused by other bacteria, such as typhoid fever, pathogenic Escherichia coli, Yersinia, Aeromonas hydrophila, other anaerobic bacteria, etc., sometimes difficult to identify from clinical, relying on pathogens when suspected And serology to confirm the diagnosis.
(3) Intestinal infections must be differentiated from salmonellosis and brucellosis.
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