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Cultures, serology, and immunohistochemical tests for Campylobacter jejuni were performed on 74 patients with inflammatory bowel disease of various disease activity and in healthy and diseased control populations. Fecal cultures were negative in all groups tested. Antibodies to C. jejuni were assessed both by a complement fixation assay and an enzyme-linked immunosorbent assay to multiple serotypes of the organism. Antibody titers in inflammatory bowel disease patients and control populations were similar, and titers in these groups were significantly lower than in patients with acute Campylobacter enteritis. Intestinal tissues examined for Campylobacter antigens by an indirect fluorescent antibody assay were negative. These data do not etiologically implicate C. jejuni in Crohn's disease or chronic ulcerative colitis.

Campylobacter fetus ss. jejuni has been recently recognized as a common human enteric pathogen; however, the pathology and pathophysiology of the enteritis caused by this agent are still largely obscure. We report 4 patients who presented with acute abdominal pain and bloody diarrhea and who had C. fetus ss. jejuni isolated from fecal cultures. Each patient showed a fourfold rise in serum IgG titer to the organism isolated. In all 4 patients colonic involvement was noted on sigmoidoscopic examination. Biopsy specimens showed acute colitis with inflammatory infiltrates of the lamina propria and crypt abscesses. Clinical improvement was complete in all patients after therapy with erythromycin. These results suggest that clinicians should consider Campylobacter enteritis in the differential diagnois of acute colitis.

A variety of bacterial pathogens including Campylobacter, Yersinia, Listeria, Brucella, and Mycobacteria have been suggested as potential etiologic agents for Crohn's disease. To assess the role of these organisms we studied responses to eight antigens in sera from patients with active Crohn's disease and healthy age- and sex-matched controls. In complement-fixation assays, the sera from the Crohn's disease patients had enhanced reactivity compared with the control sera to all seven orally ingested pathogens studied; however, only the difference in distribution of titers to Yersinia pseudotuberculosis was statistically significant (p less than 0.0025). There was no difference between the two groups in reactivity to arabinomannan, a common mycobacterial antigen. Seroreactivity to enteric pathogens not resident in the bowel flora probably represents a nonspecific sensitization to cross-reacting antigens. Lack of response to the mycobacterial antigen suggests that widespread mycobacterial disease with high bacillary load is not present in Crohn's disease.