phuluong2k
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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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| SDK
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I think it is C....... :?:
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| ssrpk
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waterfalls......giardia lamblia!
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| KEROCHI
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I would say rotavirus which is the most common cause of diarrhea in US BUt ..usually during winter time...
Any other s/sxs that would fall for Giardiasis? aside from the water source?
or that's the key to your q?
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| bactitech
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Rotavirus doesn't usually affect 29 year olds. It causes diarrhea in the very young and the very old.
The big clue here is drinking from streams. Giardia can live in these streams, and since this diarrhea has affected all three of them there needs to be a common source that will affect all age groups.
Giardia lamblia is the most common parasite isolated from feces in the US. I was at a workshop once and the instructor said that Giardiasis should be ruled out in any diarrhea lasting longer than one month. That's probably good advice.
There is a Giardia antigen kit out now that is more sensitive than an O&P exam. It also detects Cryptosporidium on the same sample. Many US labs are only performing Giardia antigens and reflexing to full O&P's only with a positive travel history. Be sure to check what route your local lab takes with this. Full O&P exams are very time consuming and, depending on patient's history and the geographic locale of the patient and lab, yield mostly negative results. That changes, however, if the patient has been out of the country, has been camping (i.e. this quiz question), is an international adoptee (I've seen multiple parasites on these poor kids), or any number of scenarios that might expose the patient to parasites. Again, a good history will guide you in ordering this testing.
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| phuluong2k
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Yeah, it is gardia
Rotavirus is common in child < 2 yrs
Norwalk is common in child > 2 yrs 8)
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| ferekide
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d..water...g lamblia....
cholerae in waterfalls.....i doubt
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