Multidrug-Resistant Campylobacter jejuni Bacteremia Case Following Sheepskin Wrap Application

Background: Campylobacter jejuni typically causes gastrointestinal illness but may lead to severe systemic infection in immunocompromised hosts. Resistance to macrolides, fluoroquinolones, and tetracyclines is increasingly reported. Case Presentation: A 27-year-old male with X-linked agammaglobulinemia developed recurrent right foot cellulitis after local trauma. Following application of a non-sterile herbal ointment and sheepskin, the lesion progressed, and the patient developed fever and chills. Blood cultures repeatedly yielded multidrug-resistant C. jejuni , while wound culture grew Citrobacter braakii . The C. jejuni isolates showed high MICs to macrolides, fluoroquinolones, and tetracycline. Given persistent bacteremia despite broad-spectrum therapy, meropenem was initiated, resulting in rapid defervescence and clinical improvement. Conclusion: This case highlights the potential for transdermal acquisition of C. jejuni in immunodeficient patients, the clinical challenges posed by multidrug-resistant strains, and the need for education regarding traditional practices that may increase infection risk.