Review Question - QID 109996

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Microbiology of Diarrhea and Food Poisoning QID: 109996 (M1.MC.20.4874)

QID 109996 (Type "109996" in App Search)

A 27-year-old man presents to the emergency room with a chief complaint of profuse and non-bloody diarrhea. He reports feeling lightheaded with intermittent and severe abdominal pain. He notes that last night for dinner, he ate a Vietnamese dish which was made with lentils, raw ground beef, and pig hooves. His temperature is 99.5°F (37.5°C), blood pressure is 107/58 mmHg, pulse is 120/min, respirations are 15/min, and oxygen saturation is 99% on room air. Physical exam demonstrates a young man with dry mucous membranes and flushed skin. The patient is started on IV fluids and a stool Guiac test is ordered which returned negative. Which of the following is a possible cause of this patient's presentation?

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Enterohemorrhagic Escherichia coli (EHEC)

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Enterotoxogenic Escherichia coli (ETEC)

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Salmonella enteriditis

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Shigella dysenteriae

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Yersinia enterocolitica

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This patient's presentation is consistent with bacterial or viral food poisoning. ETEC causes watery rather than bloody diarrhea.

ETEC causes watery diarrhea via its heat stable and labile toxin. In addition to viruses, ETEC is one of the few bacterial causes of watery diarrhea. On the other hand, the differential diagnosis of bloody diarrhea includex S. enteriditis, S. dysenteriae, C. jejuni, Y. enterocolitica, EHEC, and C. difficile.

Incorrect Answers:
Answer 1: EHEC causes bloody diarrhea and is transmitted through undercooked meat and fecal-oral contamination.

Answer 3: S. enteriditis causes bloody diarrhea and is transmitted through chicken products.

Answer 4: S. dysenteriae causes bloody diarrhea and is transmitted by fecal-oral contamination.

Answer 5: Y. enterocolitica causes bloody diarrhea and is transmitted through milk, pork, and pet feces.

Bullet Summary:
ETEC causes watery and non-bloody diarrhea.

ILLUSTRATIONS:

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