Campylobacter jejuni enterocolitis. A clinicopathologic study.

Sixteen patients with diarrhea due to Campylobacter jejuni seen within a one-year period at a general hospital were studied to review the clinical and pathological features of this illness. Campylobacter jejuni causes an acute diarrheal illness often associated with fever, delayed-onset hematochezia, and severe abdominal pain. Roentgenographically, one may see colonic and ileal ulceration. Sigmoidoscopically, the rectal appearance is similar to that from acute idiopathic ulcerative colitis, while rectal biopsy specimens show preservation of glandular architecture and a range of focal inflammatory changes. These changes are most severe in patients with a history of frank blood in stool, provided the specimens are taken within the first week of illness. No correlation between stool frequency, abdominal pain, or fever and the severity of proctitis in rectal biopsy specimens can be drawn, which suggests that the pathogenic determinants for thesse clinical manifestations may not be in the rectum, but higher in the colon or in the small intestine.