SHM Converge Scientific Abstract ePoster Gallery-An Unusual Presentation of Hallucinations With Campylobacter Jejuni Infection

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This case report describes an unusual neurologic presentation of <strong>Campylobacter jejuni</strong> infection in a 70-year-old man with a history of adenoid cystic carcinoma. He presented with 1–2 weeks of <strong>olfactory hallucinations</strong> (smelling rotting bodies) and <strong>auditory hallucinations</strong> (hearing African tribal music), along with fever, tachycardia, mild leukocytosis, and initially negative neuroimaging except for a stable tiny vestibular schwannoma. When blood cultures from his first admission later grew gram-negative rods, he was readmitted and found on CT to have <strong>transverse and descending colitis</strong>.

Cultures ultimately identified <strong>Campylobacter jejuni</strong> bacteremia. Susceptibility testing showed the organism was <strong>ciprofloxacin-resistant</strong> but <strong>erythromycin- and tetracycline-susceptible</strong>. He was treated initially with ceftriaxone, then meropenem, and was discharged on oral doxycycline to complete a 7-day course. He improved quickly and had <strong>resolution of hallucinations and diarrheal symptoms</strong> on follow-up.

The discussion highlights that <strong>C. jejuni</strong> is a common bacterial cause of diarrhea and is best known for neurologic complications such as <strong>Guillain-Barré syndrome</strong>, which is thought to result from molecular mimicry between bacterial lipooligosaccharides and nerve gangliosides. Less common complications include <strong>acute encephalopathy</strong> and <strong>acute disseminated encephalomyelitis (ADEM)</strong>, though their mechanisms are unclear. The authors note that <strong>isolated auditory or olfactory hallucinations have not previously been reported</strong> with Campylobacter infection.

The case also underscores the growing clinical importance of <strong>fluoroquinolone resistance</strong> in Campylobacter, likely driven by antibiotic use in humans and livestock, and its impact on treatment decisions in bacteremia and other invasive infections.

Asset Subtitle

Emily Ruseski

Meta Tag

Author List Christine Bryson, Emily Ruseski, Natalya Maharaj, Satoko Igarashi

Category Clinical Vignettes

Concept Campylobacter jejuni

Concept Diarrheal Illness

Concept Antibiotic susceptibility

Concept Fluoroquinolone Resistance

Concept Antimicrobial Therapy

Distinguished Non-Finalist

Presenter Organization Baystate Medical Center

Presenting Author Emily Ruseski

Track Adult

Keywords

Campylobacter jejuni

olfactory hallucinations

auditory hallucinations

bacteremia

transverse colitis

fluoroquinolone resistance

Guillain-Barré syndrome

acute encephalopathy

acute disseminated encephalomyelitis

ciprofloxacin-resistant

Campylobacter jejuni

Diarrheal Illness

Antibiotic susceptibility

Fluoroquinolone Resistance

Antimicrobial Therapy