Campylobacter jejunimeningitis- a case report and review of literature

Campylobacter spp. rod je bakterija koji primarno uzrokuje infekcije gastrointestinalnog sustava. Prirodno stanište im je probavni sustav ptica i sisavaca, a čovjek se zarazi feko-oralnim putem, konzumirajući životinjske proizvode. Najčešći patogen u rodu je bakterija Campylobacter jejuni. Ona je odgovorna za 80% svih kampilobakterioza. Kampilobakteri rijetko uzrokuju ekstraintestinalne infekcije, tada je najčešći uzročnik Campylobacter fetus. Klinička slika tih infekcija varira od prolazne bakterijame pa sve do lokaliziranih infekcija kao što su meningitis, septički artritis, endokarditis, peritonitis i kolecistitis. C. jejuni kao uzročnik meningitisa opisan je samo u izoliranim slučajevima, pojedinačno kod imunokompromitiranih pacijenata nakon neurokirurških zahvata ili s ugrađenim sustavom za odvodnju likvora te kao manje epidemije u novorođenačkoj populaciji. Ovaj rad prikazuje slučaj pacijentice koja je zbog akutnog bakterijskog meningitisa liječena u Klinici za infektivne bolesti „dr. Fran Mihaljević“ u Zagrebu. Pacijentica je imala adenokarcinom pluća s moždanim metastazama te je liječena kemoterapijom, radioterapijom i kortikosteroidima. Zbog same prirode bolesti i posljedičnih terapijskih postupaka bila je imunokompromitiranog stanja. Rijedak uzročnik detektiran je iz cerebrospinalnog likvora metodom 16S rDNA, a naknadnom izolacijom uzročnika iz krvi ustanovljena je i njegova rezistencija na ciprofloksacin. Slučaj prikazan u ovom radu doprinosi dosadašnjim oskudnim podatcima o ovoj rijetkoj manifestaciji infekcija prouzročenih kampilobakterima.Campylobacter spp. is a genus of Gram-negative bacteria that primarily causes gastrointestinal infections. Their main natural reservoir is a digestive system of birds and mammals. Humans can get infected through fecal-oral route of transmission, by consumption of animal products. Most common pathogen is Campylobacter jejuni. C. jejuni is the main causes of bacterial foodborne disease in many developed countries and it’s responsible for 80% of all campylobacter infections. Campylobacters rarely cause extraintestinal infections. When they occur, they’re most commonly caused by Campylobacter fetus. Clinical presentation of such infections varies from transient bacteremia to localized infections such as meningitis, septic arthritis, endocarditis, peritonitis and cholecystitis. Meningitis caused by C. jejuni is only described in isolated cases. It occurred in immunocompromised patients after neurosurgical procedures or with a built-in drainage system and as a minor epidemic in the newborn population. This paper presents the case of a patient who has been treated for an acute bacterial meningitis at the Clinic for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb. Patient had a metastatic lung adenocarcinoma and was treated with chemotherapy, radiotherapy and corticosteroids. Due to nature of the disease and consequent therapeutic procedures, patient was in an immunocompromised condition. The rare pathogen was detected from the cerebrospinal fluid by 16S rDNA method, and the subsequent isolation of microorganism from the blood showed its resistance to ciprofloxacin. Case presented in this paper contributes to scarce data on this rare occurrence of campylobacter infections