shawky2005
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After a summertime camping trip in the Cascade mountains of Washington state, a 29-year-old man has developed a mild watery diarrhea for the past week. While on the trip he drank water from the mountain streams. A physical examination reveals no abdominal pain or masses. He is afebrile. Bowel sounds are present. His stool is negative for occult blood. The diarrhea abates in 3 weeks. His two children are simiarly affected. Which of the following infectious agents most likely caused his disease?
A Rotavirus
B Shigella flexneri
C Vibrio cholerae
D Giardia lamblia
E Entamoeba histolytica
F Cryptosporidium parvum
G Salmonella enteritidis
H Norovirus
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| bluedusk
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Gotta go with the lamblia.
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| Ria
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Ya it has to be Giardia Lamblia as the mention of the driking water up in the mountains plus it lasts for 3 weeks
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| Malaysian
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whats the answer??
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| shawky2005
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yes it is Giardia lamblia
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| sofianee
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I agree that from the options, the most likely is G.Lambia...but the diarrhea hasn't to be greassy, frothy & smelly (due to the fat malabsorbtion)...and should be accompagnied with a gassy distention & cramps....
Am I wrong thinking so?..
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| Malaysian
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Yes I agree with you....without that distinguishing point its not possible to say its giardia.....it might as well be vibrio since he has spread it to his children or salmonella.
Is mountaIN stream drinking water synonymous with giardia infection??
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| mjl1717
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There is a WIDE spectrum here: As sofianee said the common symptoms were not give (In fact no symptoms given, only the sign of mild watery diarrhea ) No, drinking water from a mountain is not the definitive hint but a mild hint. If he had any CNS or meningeal signs-we could have thought of Naegleria gruberi or Naegleria fowleria maybe thats stretching it but there is nausea and vomiting. Perhaps Ill return and go over the distractors.
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| Sakaki-
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Vibrio would not result in "mild diarrhea", and salmonella is usually accompanied by a low-grade fever. Moreover, 3 weeks is much too long for a salmonella infection.
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| shawky2005
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This is the explanation combined with the question ......
(A) Incorrect. Rotavirus infection is usually seen in children under age 6.
(B) Incorrect. Shigellosis is a more severe disease. Shigella is not likely to be found up in the mountains, but in food with fecal contamination.
(C) Incorrect. Vibrio cholerae is the cause for cholera, which produces a profuse, watery diarrhea that is life-threatening.
(D) CORRECT. Giardiasis is typically a non-life threatening nuisance in immunocompetent persons. The organisms are found in contaminated water, particularly in areas such as apparently pristine, remote, mountains not considered to be a risk for infectious diseases. He had not read his Sierra Club guide in regards to treatment of drinking water.
(E) Incorrect. Amebiasis is more common in developing nations. There can be inflammatory bowel disease and some mucosal ulceration may be present.
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