How should I manage a patient with Campylobacter gastroenteritis who presents with severe dehydration?

Management of a patient with Campylobacter gastroenteritis presenting with severe dehydration involves:

• Immediate assessment and recognition of severity: Identify signs of severe dehydration or shock such as altered responsiveness, sunken eyes, dry mucous membranes, tachycardia, weak peripheral pulses, prolonged capillary refill time, and hypotension. These signs necessitate urgent intervention ¹.
• Intravenous fluid therapy: Initiate intravenous rehydration using isotonic solutions such as 0.9% sodium chloride or 0.9% sodium chloride with 5% glucose to replace fluid deficit and maintain hydration. Fluid replacement should be done cautiously, especially if hypernatraemic dehydration is suspected, with slow correction over approximately 48 hours and frequent monitoring of plasma sodium to avoid rapid shifts ¹.
• Laboratory monitoring: Measure plasma sodium, potassium, urea, creatinine, and glucose concentrations to guide fluid management. If shock is suspected, assess venous blood acid–base status and chloride concentration ¹.
• Oral rehydration therapy (ORT): Once the patient stabilizes and can tolerate oral intake, gradually introduce oral rehydration solutions to complete rehydration. If tolerated, intravenous fluids can be stopped and replaced by ORT ¹.
• Antibiotic therapy: Routine antibiotics are not recommended for uncomplicated Campylobacter gastroenteritis. Antibiotics should be reserved for cases with suspected or confirmed septicaemia, extra-intestinal spread, immunocompromised status, or other specific indications. Seek specialist advice if needed ¹.
• Supportive care: Avoid antidiarrhoeal medications. After rehydration, encourage normal feeding and fluid intake, avoiding fruit juices and carbonated drinks until diarrhoea resolves ¹.
• Escalation of care: Arrange emergency transfer to secondary care if the patient shows signs of shock or deteriorates clinically ¹.