The presence of blood and leukocytes in the stools of patients who have Campylobacter enteritis strongly suggests that mucosal invasion, necrosis, and inflammation occur at these small bowel sites. Frequent, profuse, watery diarrhea associated with periumbilical cramping raises the possibility of small bowel secretory disease. C. jejuni is susceptible to the nonspecific host defenses of gastric pH, normal gut motility, and serum complement. However, severe, recurrent, and prolonged intestinal infections as well as extraintestinal infections have occurred in patients with hypogammaglobulinemia. In addition, the increased incidence of severe infections in AIDS patients suggests that cellular immunity may also be important.
Patients complain of fever, malaise, headache, chills, night sweats, and anorexia.
Lethargy and confusion without focal neurologic findings are common, as is nonproductive cough without objective pulmonary findings. Abdominal pain, often colicky, presents frequently, although diarrhea is observed in only about one third of patients. A gamut of bacteremic syndromes has been reported, ranging from transient asymptomatic bacteremia to acute fulminant sepsis to chronic bacteremia with associated fever lasting weeks to months. Neonates are at particular risk for meningitis. An unusual manifestation is thrombophlebitis, which can occur bilaterally, particularly at sites of previous venipunctures.