{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:23:06Z","timestamp":1782739386970,"version":"3.54.5"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2016,4,12]],"date-time":"2016-04-12T00:00:00Z","timestamp":1460419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin\u2019s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and\/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy.<\/jats:p>","DOI":"10.3390\/ijms17040544","type":"journal-article","created":{"date-parts":[[2016,4,12]],"date-time":"2016-04-12T10:57:33Z","timestamp":1460458653000},"page":"544","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin\u2019s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis"],"prefix":"10.3390","volume":"17","author":[{"given":"Maria","family":"Gallo","sequence":"first","affiliation":[{"name":"Department of Clinical Pathology and Microbiology, San Gallicano Institute, IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6295-6006","authenticated-orcid":false,"given":"Enea","family":"Di Domenico","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Microbiology, San Gallicano Institute, IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0058-1381","authenticated-orcid":false,"given":"Luigi","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, San Gallicano Institute, IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Marchesi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorella","family":"Pelagalli","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Manghisi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Microbiology, San Gallicano Institute, IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorentina","family":"Ascenzioni","sequence":"additional","affiliation":[{"name":"Department of Biology and Biotechnology \u201cCharles Darwin\u201d, University of Rome Sapienza, Rome 00185, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Prignano","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Microbiology, San Gallicano Institute, IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mengarelli","sequence":"additional","affiliation":[{"name":"Department of Hematology, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Ensoli","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Microbiology, San Gallicano Institute, IRCCS, Rome 00144, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1038\/nrmicro1718","article-title":"Campylobacter jejuni: Molecular biology and pathogenesis","volume":"5","author":"Young","year":"2007","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1086\/591530","article-title":"Campylobacter bacteremia: Clinical features and factors associated with fatal outcome","volume":"47","author":"Pacanowski","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.ijid.2015.01.002","article-title":"Misidentification of Streptococcus uberis as a human pathogen: A case report and literature review","volume":"33","author":"Toma","year":"2015","journal-title":"Int. J. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1469-0691.2009.02900.x","article-title":"Bacteraemia as a result of Campylobacter species: A population-based study of epidemiology and clinical risk factors","volume":"16","author":"Nielsen","year":"2010","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","first-page":"349","article-title":"Campylobacter jejuni bacteremia and Guillain-Barre\u00b4 syndrome in a patient with GVHD after allogeneic BMT","volume":"13","author":"Hagensee","year":"1994","journal-title":"Bone Marrow. Transplant."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1086\/318514","article-title":"Practice guidelines for the management of infectious diarrhea","volume":"32","author":"Guerrant","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Nachamkin, I., Szymanski, C.M., and Blaser, M.J. (2008). Campylobacter, ASM Press.","DOI":"10.1128\/9781555815554"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.mimet.2013.06.021","article-title":"Antimicrobial resistance in campylobacter: Susceptibility testing methods and resistance trends","volume":"95","author":"Ge","year":"2013","journal-title":"J. Microbiol. Methods."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/jac\/27.2.199","article-title":"Quinolone resistance in Campylobacter isolated from man and poultry following the introduction of fluoroquinolones in veterinary medicine","volume":"27","author":"Endtz","year":"1991","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1136\/jcp.52.9.709","article-title":"Increasing rates of ciprofloxacin resistant Campylobacter","volume":"52","author":"Sam","year":"1999","journal-title":"J. Clin. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2217\/17460913.4.2.189","article-title":"Antibiotic resistance in Campylobacter: Emergence, transmission and persistence","volume":"4","author":"Luangtongkum","year":"2009","journal-title":"Future Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Nachamkin, I., Szymanski, C.M., and Blaser, M.J. (2008). Campylobacter, ASM Press.","DOI":"10.1128\/9781555815554"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1128\/AAC.05516-11","article-title":"Impaired fitness and transmission of macrolide-resistant Campylobacter jejuni in its natural host","volume":"56","author":"Luangtongkum","year":"2012","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.4315\/0362-028X-70.8.1945","article-title":"Development of macrolide-resistant Campylobacter in broilers administered subtherapeutic or therapeutic concentrations of tylosin","volume":"70","author":"Ladely","year":"2007","journal-title":"J. Food Prot."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1128\/AAC.01411-06","article-title":"Effect of macrolide usage on emergence of erythromycin-resistant Campylobacter isolates in chickens","volume":"51","author":"Lin","year":"2007","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_16","unstructured":"Mandell, G.L., Bennett, J.E., and Dolin, R. (2006). Mandell, Douglas and Bennett\u2019s Principles and Practice of Infectious Diseases, Churchill Livingstone. [6th ed.]."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.2169\/internalmedicine.47.1161","article-title":"Combined treatment with oral kanamycin and parenteral antibiotics for a case of persistent bacteremia and intestinal carriage with Campylobacter coli","volume":"47","author":"Okada","year":"2008","journal-title":"Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.6004\/jnccn.2012.0146","article-title":"Prevention and treatment of cancer-related infections","volume":"10","author":"Baden","year":"2012","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/00006454-198909000-00022","article-title":"In vitro evaluation of antibiotics for treatment of meningitis caused by Campylobacter fetus subsp fetus","volume":"8","author":"Morroka","year":"1989","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.3201\/eid1006.030669","article-title":"Quinolone-resistant Campylobacter infections: Risk factors and clinical consequences","volume":"10","author":"Engberg","year":"2004","journal-title":"Emerg. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e5368","DOI":"10.1136\/bmj.e5368","article-title":"Prevention and management of neutropenic sepsis in patients with cancer: Summary of NICE guidance","volume":"345","author":"Phillips","year":"2012","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1128\/AAC.35.5.813","article-title":"Role of the b-lactamase of Campylobacter jejuni in resistance to b-lactam agents","volume":"35","author":"Lachance","year":"1991","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1128\/AAC.40.8.1924","article-title":"Antimicrobial susceptibilities of Campylobacter jejuni and Campylobacter coli to 12 b-lactam agents and combination with b-lactamase inhibitors","volume":"40","author":"Tajada","year":"1996","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1128\/JCM.41.1.463-466.2003","article-title":"Epidemiology and antimicrobial susceptibilities of 111 Campylobacter fetus subsp. fetus strains isolated in Quebec, Canada, from 1983 to 2000","volume":"41","author":"Tremblay","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1128\/jcm.23.4.709-714.1986","article-title":"Detection of pathogenic Campylobacter species in blood culture systems","volume":"23","author":"Wang","year":"1986","journal-title":"J. Clin. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1556\/EuJMI.2.2012.1.11","article-title":"Campylobacter bacteremia: A rare and under-reported event?","volume":"2","author":"Louwen","year":"2012","journal-title":"Eur. J. Microbiol. Immunol. (Bp)."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1111\/j.1469-0691.2010.03328.x","article-title":"Accuracy of the API Campy system, the Vitek 2 Neisseria-Haemophilus card and matrix-assisted laser desorption ionization time-of-flight mass spectrometry for the identification of Campylobacter and related organisms","volume":"17","author":"Martiny","year":"2011","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/107327489800500410","article-title":"Campylobacter Jejuni Bacteremia in an HIV-Positive Patient with Non-Hodgkin\u2019s Lymphoma","volume":"5","author":"Callahan","year":"1998","journal-title":"Cancer Control."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/j.amjmed.2013.07.003","article-title":"Campylobacter jejuni and cytopenias","volume":"126","author":"Schattner","year":"2013","journal-title":"Am. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/MD.0b013e3181f2638d","article-title":"Campylobacter bacteremia: Clinical characteristics, incidence, and outcome over 23 years","volume":"89","author":"Mohedano","year":"2010","journal-title":"Medicine (Baltimore)"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jdermsci.2007.09.001","article-title":"Recent advances in cutaneous lymphomas","volume":"48","author":"Dummer","year":"2007","journal-title":"J. Dermatol. Sci."},{"key":"ref_32","first-page":"202","article-title":"Managing infection in cancer patients and other immunocompromised children","volume":"12","author":"Steele","year":"2012","journal-title":"Ochsner J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1128\/JCM.39.1.14-23.2001","article-title":"Multilocus sequence typing system for Campylobacter jejuni","volume":"39","author":"Dingle","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"949","DOI":"10.3201\/eid0809.02-0122","article-title":"Molecular characterization of Campylobacter jejuni clones: A basis for epidemiologic investigation","volume":"8","author":"Dingle","year":"2002","journal-title":"Emerg. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Morris, G.A., Ikumapayi, U.N., Antonio, M., Howie, S.R., and Adegbola, R.A. (2008). A novel Campylobacter jejuni sequence type from a culture-negative patient in the Gambia. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0001773"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1128\/JCM.01489-10","article-title":"New methods for detection of Campylobacters in stool samples in comparison to culture","volume":"49","author":"Bessede","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1128\/JCM.01991-08","article-title":"Utility of pyrosequencing in identifying bacteria directly from positive blood culture bottles","volume":"47","author":"Jordan","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/S0924-8579(09)70559-X","article-title":"Blood culture systems: Rapid detection\u2014How and why?","volume":"34","author":"Gaibani","year":"2009","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"4771","DOI":"10.1128\/JCM.40.12.4771-4775.2002","article-title":"Are there naturally occurring pleomorphic bacteria in the blood of healthy humans?","volume":"40","author":"McLaughlin","year":"2002","journal-title":"J. Clin. Microbiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1111\/j.1469-0691.2010.03290.x","article-title":"Detection of microorganisms in blood specimens using MALDI-TOF mass spectrometry: A review","volume":"16","author":"Drancourt","year":"2010","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s12223-008-0061-7","article-title":"Species identification of Campylobacter jejuni ssp. jejuni and C. coli by matrix-assisted laser desorption\/ionization time-of-flight mass spectrometry and PCR","volume":"53","author":"Kolinska","year":"2008","journal-title":"Folia Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1021\/pr050485w","article-title":"Sub-speciating Campylobacter jejuni by proteomic analysis of its protein biomarkers and their posttranslational modifications","volume":"5","author":"Fagerquist","year":"2006","journal-title":"J. Proteome Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.clinbiochem.2010.06.017","article-title":"MALDI-TOF mass spectrometry tools for bacterial identification in clinical microbiology laboratory","volume":"44","author":"Carbonnelle","year":"2011","journal-title":"Clin. Biochem."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1128\/JCM.02485-09","article-title":"Real time identification of bacteria and yeast in positive blood culture broths by MALDI-TOF-mass spectrometry","volume":"48","author":"Ferroni","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1128\/JCM.01831-09","article-title":"Rapid identification of bacteria from positive blood culture bottles using MALDI-TOF mass spectrometry fingerprinting","volume":"48","author":"Christner","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.nmni.2015.12.004","article-title":"Direct blood culturing on solid medium outperforms an automated continuously monitored broth-based blood culture system in terms of time to identification and susceptibility testing","volume":"10","author":"Idelevich","year":"2016","journal-title":"New Microbes New Infect."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/17\/4\/544\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:22:07Z","timestamp":1760210527000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/17\/4\/544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,12]]},"references-count":46,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,4]]}},"alternative-id":["ijms17040544"],"URL":"https:\/\/doi.org\/10.3390\/ijms17040544","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,12]]}}}