Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE.

Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR.

Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was 10.2 ± 5.0 years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications.

Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.

The acute diarrhea is a common complaint among immunocompromised hosts, and may cause life threatening event. The infectious etiologies vary depending on virus, bacteria, and parasites. The most common etiology of acute gastroenteritis is known as enteric virus in Korea.1 But there are few studies about the infectious etiology of acute gastroenteritis in immunocompromised hosts.23 The aim of this study was to investigate the infectious etiologies of acute diarrhea in immunocompromised hosts.

Seventy three patients were enrolled prospectively in a university hospital from January 2013 to July 2014. Immunocompromised hosts included above 65-year-old people, patients with chronic diseases, solid organ or stem cell transplants, solid organ malignancies, hematologic malignancies, immunosuppressive or steroid taking patients. The clinical data were collected and stool samples collected during diarrhea were undergone laboratory analysis for enteric viruses and bacterial enteropathogens including Salmonella spp., Shigella spp., and Clostridium difficile.

Fifty five patients were analyzed as follows : above 65 year-old people were 36 cases (66%), previous antibiotic usage was 22 cases (41.5%). 44 cases (81.1%) were admitted to general ward whereas 9 cases to ICU (17%). 41 cases (73.6%) were treated with antibiotics. Positive C. difficile toxin assays were 6 cases (11.9%). Other infectious etiologies were not found.

C. difficile infection was more common infectious etiology while enteric viruses and other bacteria are not associated with acute diarrhea among immunocompromised hosts in this study. So C. difficile infection must be considered preferentially in immunocompromised hosts with acute diarrhea.