Clinical Features, Immunological Characteristics, and Treatment Outcomes of Campylobacter spp. Infections in Patients With Common Variable Immunodeficiency

Possible Role of Cytomegalovirus in Gastric Cancer Development and Recurrent Macrolide-Resistant Campylobacter jejuni Infection in Common Variable Immunodeficiency: A Case Report and Literature Discussion

“…Poor adherence to treatment and gastrointestinal protein loss probably contributed to the inadequate IgG levels. Decreased T cell levels have also been observed previously [ 14 , 19 ], suggesting the presence of T cell dysfunction in CVID patients. The patient’s immunodeficiency and the use of concomitant immunosuppression may also contribute to T cell depletion, increasing susceptibility to infection.…”

“…C. jejuni is one of the most common causes of gastrointestinal infections in patients with CVID [ 14 ]. Such immunocompromised patients are more likely to develop severe complications after C. jejuni infection, to suffer from a chronic carrier status, or to have recurrent symptomatic episodes over years [ 13 ].…”

“…To date, the available literature is mainly limited to individual reports or series of CVID patients suffering from chronic or recurrent C. jejuni infection and/or complications such as bacteremia [ 9 , 15 , 16 , 17 , 18 , 19 ]. However, a cohort study of CVID patients with Campylobacter infection has recently been published [ 14 ]. Similar to the other previously reported cases, the patient presented with diarrhea, other gastrointestinal symptoms, and weight loss.…”

“…However, macrolide-resistant strains have increased in recent years and are a major concern in developed countries [ 28 ]. In previous studies of CVID patients, antibiotic resistance was common, especially to macrolides and fluoroquinolones [ 14 ]. In our case, the failure of treatment with azithromycin and erythromycin led to a request for an antibiogram, which revealed the presence of a macrolide-resistant strain sensitive to imipenem and fosfomycin.…”

“…In our case, the failure of treatment with azithromycin and erythromycin led to a request for an antibiogram, which revealed the presence of a macrolide-resistant strain sensitive to imipenem and fosfomycin. Currently, an antibiotic treatment strategy for immunocompromised patients with recurrent Campylobacter infections is not established, although some workflow therapeutic strategies have been proposed [ 14 ]. In our case, we chose to maintain carbapenems, broad-spectrum antibiotics that are usually effective in multi-resistant cases and those complicated by bacteremia, together with gentamicin for a prolonged period.…”