Cytopenia in Campylobacter jejuni Enteritis Patients

Campylobacter jejuni ( C. jejuni ) enteritis is generally self-limited, but occasionally triggers extraintestinal associated sequelae. We examined whether cytopenia is associated with C. jejuni enteritis. A retrospective case-controlled study of C. jejuni and Escherichia coli ( E. coli ) enteritis patients, who were microbiologically confirmed in our hospital from February 2006 to October 2017, was conducted. Leukocytopenia and thrombocytopenia were defined as statuses less than 4.0 × 10 9 /L and 130 × 10 9 /L during their clinical courses, respectively. Clinical and microbiological data were collected. Risk factors for cytopenia were assessed by a multivariate analysis. The two eligible cohorts comprised 138 C. jejuni (71 inpatients) and 35 E. coli (34 inpatients) enteritis patients. The prevalence of leukocytopenia or thrombocytopenia in the C. jejuni patients was 7.9% (11/138) and 5.0% (7/138), and that in the E. coli patients was 0% (0/35) and 5.7% (2/35), respectively. Leukocytopenia was more prevalent in the C. jejuni enteritis inpatients than in the E. coli inpatients, but there were no significant differences in thrombocytopenia in both cohorts. The mean minimum leukocyte values were determined after an average of three admission days in the C. jejuni inpatients. The elevations of C-reactive protein and creatinine were risk factors for thrombocytopenia and leukocytopenia, respectively. Hemophagocytosis was detected in a C. jejuni enteritis patient with cytopenia. The present study suggested that leukocytopenia is a possible extraintestinal sequela in some C. jejuni enteritis patients. Hemophagocytosis should be considered as one of underlying mechanisms when cytopenia is found in these patients.