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From question on page 758

Figure 1 shows florid deep discrete ulcerations in the right colon. The patient was commenced on gentamicin 4 mg/kg once a day and metronidazole 500 mg three times a day. Campylobacter jejuni (serotype HS12 PT1) was isolated from a faecal specimen submitted on admission. A five day course of azithromycin was added to the therapy. Biopsies were in keeping with an infective aetiology. He responded well to antibiotics and was discharged home on day 9 of admission and has remained well thereafter.

Campylobacter jejuni is a zoonotic infection and the most common cause of diarrhoea and bacterial enterocolitis in the UK. The incubation period ranges from 1 to 11 days (usually 2–5) and the disease process is usually self limiting over 5–7 days. Therapy consists of oral rehydration. In those with severe illness with fever, blood in stools and prolonged course of illness however, antibiotic therapy is indicated either with ciprofloxacin or a macrolide such as erythromycin or azithromycin.

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