Differential clinical and epidemiological features in children with Campylobacter diarrhoea, mixed-agent diarrhoea and Campylobacter diarrhoea plus parenteral infections.

A prospective study of 111 young Peruvian children with Campylobacter jejuni diarrhoea showed that it behaves as an endemic enterotoxigenic-like, waterborne, milkborne, and zoonotic disease. Although there were no definite differential features between pure C. jejuni diarrhoea, mixed-agent diarrhoea, and C. jejuni diarrhoea plus parenteral infections, children with C. jejuni diarrhoea plus parenteral infections were all inpatients, were more frequently malnourished and more frequently exhibited systemic symptoms. Campylobacter jejuni associated with other enteric pathogens did not seem to act synergistically as the disease was not particularly severe in this group.

Acute diarrhoea and Campylobacter in Peruvian children: a clinical and epidemiologic approach.

A study performed on Peruvian children < 10 years of age and their controls showed that Campylobacter jejuni is a leading cause of diarrhoea. Infants 1 year old or younger were the most affected. The disease was usually moderately severe, although > 50 per cent of patients required i.v. fluid therapy. Campylobacter was also more frequent in malnourished patients, who come from socio-economically deprived groups, with overcrowding, poor sanitation, and frequent contact with domestic birds and animals. The seasonal behaviour suggests that diarrhoea caused by Campylobacter is endemic in this area.

Occult blood and fecal leukocytes as screening tests in childhood infectious diarrhea: an old problem revisited.

During a 24-month period 446 children with diarrhea and 16 controls had examination of their stools for leukocytes and for occult blood. Fecal leukocytes were found in 36, 16 and 18% of children with Salmonella-Shigella-Campylobacter, rotavirus or enterotoxigenic Escherichia coli, or cryptosporidial diarrhea, respectively. Similarly 43, 39 and 38% of these groups, respectively, as well as 13% of controls had occult blood. Notably 70% of 10 Shigella cases had fecal leukocytes. In 166 children with mixed pathogens leukocytes were seen in 27 and 8% of children with Salmonella-Shigella-Campylobacter or noninvasive pathogen, respectively. Likewise 44 and 18% of these groups had occult blood. Agreement between both tests being positive was poor, the highest result being 50% for Shigella. Dysentery combined with both tests positive was associated with 15 (88%) cases of invasive agents present in stool cultures, and combination of dysentery with fecal leukocytes was associated with 21 (72%) cases of invasive agents recovered. The results of these tests should be interpreted in the context of the clinical situation. A combined clinical-epidemiologic and screening tests-based approach to infectious diarrhea of childhood is suggested.