Cellulitis and Septic Arthritis Caused by Campylobacter fetus and Campylobacter jejuni

Bacteremia caused by gram-negative bacteria occasionally causes soft tissue infections, including cellulitis and septic arthritis. We describe 1 patient each with Campylobacter fetus cellulitis and septic arthritis and review the world literature with regard to C. fetus and C. jejuni infections at these sites. Altogether, 14 patients with cellulitis (12 due to C. fetus and 2 due to C. jejuni) and 20 patients with septic arthritis (15 due to C. fetus and 4 caused by C. jejuni) have been described. Most infections, particularly those causing cellulitis, are found in elderly men with underlying systemic disease. Most patients are febrile but less than half manifest a leukocytosis. There were only 3 deaths in this series of 33 patients. The newer macrolides, including azithromycin and clarithromycin, are considered the drugs of choice, particularly with C. jejuni, while soft tissue infections caused by C. fetus respond nicely to many beta-lactams, particularly to cephalosporins and carbapenems, as well as to macrolides and quinolones.