Bickerstaff's brainstem encephalitis related to Campylobacter jejuni gastroenteritis
- Abid Hussain (abid.m.hussain{at}uhl-tr.nhs.uk)
- Neil Flint (neil.flint{at}uhl-tr.nhs.uk)
- Shaun Livsey (shaun.livsey{at}uhl-tr.nhs.uk)
- Richard Wong (richard.wong{at}uhl-tr.nhs.uk)
- Paul Spiers (paul.spiers{at}uhl-tr.nhs.uk)
Abstract
Campylobacter species are microaerophilic spiral-shaped Gram-negative bacilli which cause diarrhoeal and systemic illness in humans and animals. They are the most commonly identified cause of bacterial intestinal disease in the United Kingdom and elsewhere in the developed world. The bacterial cell wall of the organism contains an endotoxin which, when released, can result in acute enteritis and complications such as reactive arthritis, erythema nodosum, peripheral neuropathy, haemolytic uraemic syndrome and Bickerstaff’s brain stem encephalitis. Here we report a case of Bickerstaff’s brainstem encephalitis following a gastro-intestinal infection with Campylobacter jejuni. The patient presented with acute onset of confusion and ophthalmoplegia. The cerebrospinal fluid (CSF) showed lymphocytosis, pleocytosis and raised protein. This acute presentation was preceded by an episode of Campylobacter-related diarrhoea as confirmed by high titres of Campylobacter-specific IgM antibodies.
