SHM Converge Scientific Abstract ePoster Gallery-An Atypical Presentation of Campylobacter Bacteremia

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This case report describes an atypical presentation of <strong>Campylobacter fetus bacteremia</strong> in a 47-year-old man with <strong>well-controlled HIV</strong> and methamphetamine use who initially came to the emergency department with <strong>acute chest pain</strong>, shortness of breath, low-grade fever, hypotension, leukocytosis, and dysuria after unprotected sex. His EKG, chest X-ray, troponins, and transthoracic echocardiogram were unrevealing, and the chest pain improved spontaneously, so he was discharged with suspected stimulant-related symptoms. After discharge, however, blood cultures grew <strong>curved gram-negative bacilli</strong>, later identified as <strong>Campylobacter fetus</strong>, and urine testing was positive for <strong>gonorrhea</strong>.

He returned five days later without recurrent chest pain but with malaise, one episode of diarrhea, and persistent dysuria. Repeat blood cultures were negative, and his CD4 count was robust. Because <strong>C. fetus</strong> can cause <strong>endovascular infection</strong>, especially in immunocompromised patients or men who have sex with men, Infectious Disease recommended <strong>CTA chest</strong> to evaluate for aortic involvement given his chest pain. Imaging showed a top-normal ascending aorta without evidence of aortic wall thickening, dissection, or aneurysm.

He was treated with a <strong>21-day course of amoxicillin-clavulanate and doxycycline</strong>. The case highlights that <strong>C. fetus</strong> is an uncommon Campylobacter species but is the one most associated with <strong>bacteremia and endovascular disease</strong>. Although classically foodborne, emerging data suggest possible person-to-person transmission. Reported effective antibiotics include <strong>ampicillin, third-generation cephalosporins, aminoglycosides, imipenem, and meropenem</strong>, but the optimal duration of therapy remains uncertain. Because infections may be <strong>persistent or relapsing</strong>, close follow-up is important.

Asset Subtitle

Marie DiMattia

Meta Tag

Author List Marie DiMattia, Sonia Bharel

Category Clinical Vignettes

Concept Campylobacter fetus

Concept Bacteremia

Concept Endovascular infection

Concept Antimicrobial Therapy

Concept Immunocompromised State

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University Hospital

Presenting Author Marie DiMattia

Track Adult

Keywords

Campylobacter fetus

bacteremia

well-controlled HIV

acute chest pain

endovascular infection

gonorrhea

curved gram-negative bacilli

CTA chest

amoxicillin-clavulanate

doxycycline

Campylobacter fetus

Bacteremia

Endovascular infection

Antimicrobial Therapy

Immunocompromised State