drdg
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A 25-year-old white male from Arizona develops malaise, abdominal cramps, and diarrhea during his 15-day business trip to Mexico. His stools are watery, non-bloody and non-mucoid. He also complains of low-grade fever. His pulse is 80/min, blood pressure is 120/86 mmHg, and temperature is 37.1 C. Abdominal and rectal exam are unremarkable. Stool exam is negative for leukocytes. Wich of the following organisms is the most likely cause of his diarrhea?
A. Giardia
B. Cyclospora
C. E. Coli
D. Vibrio Cholerae
E. Salmonella
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| neuroblastoma
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A
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| doc_clotaire
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agreed
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| titly
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| drgeorgie
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why not C ? traveller's diarrhea?
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| hanialkhadher
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C. E. Coli 
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| Ivonne
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I will go wit C . Traveler diarrhea
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| hgheith
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i believe e.coli (enterotoxic) and Giardiasis both don;t produce fever.
The only other one that I think might be what this guy has is Cholera?
D. Vibrio Cholerae
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| spmvj
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C.E.coli.
Low grade fever is present in both e.coli&giardiasis.Vibrio cholera does not cause fever.
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| drdg
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Yes, the correct answer is C.
E. Coli for Traveler diarrhea
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| hgheith
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Actually in step up to medicine it's the other way around, E.coli and Giardiasis do not cause fever and vibrio causes low grade fever.
Where is this Q from drdg?
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| mjl1717
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isnt Guardia associated with the bulky foul smelling stool?/ tip off was a the white male who traveled to Mexico!
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| RitaM
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I agree with E coli as it is common in Mexico
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| doyoudig
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Giardia -- Foul Smelling Stool, Abd Bloating
E Coli - MCC of Traverlers Diarrhea
Vibrio -- No Info on Fish Intake....
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| neuroblastoma
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Enterotoxigenic E. coli is one of the most common causes of traveler’s diarrhea but it is a rare cause of diarrhea in USA.
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| neuroblastoma
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i am still confused... in ques Stool exam is negative for leukocytes.... i guess in ecoli it should be positive...
please help...
stool leuckocytes present in........??????????
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| mjl1717
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doyoudig wrote:
Giardia -- Foul Smelling Stool, Abd Bloating
E Coli - MCC of Traverlers Diarrhea
Vibrio -- No Info on Fish Intake....
Good, its about communicating big time! (if the person can do it) As I remember Salmonella has bloody diarrhea.
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| hgheith
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Enterotoxic E. Coli doesn't have blood/leukocytes in stool, this is the traveler's diarrhea and is common in this side of the world even here in the US, but mostly S. America. Enteroinvasive E.Coli produces the blood in the stool (this one is the famous 0157:H7 associated with HUS)
I remember Giardia "Lamblia" becuase u get the foul smelling greasy fatty stool, and lamb is very fatty. (my pneumonic  )
Also I remember that Cholera is spread via the fecal oral route, it can be from injestion of contaminated food or water and is more common in developing countries, its the other vibrio that is associated with seafood.
I agree to the most common is travler's diarrhea, the only problem I have with this Q is the fact that this guy has a low grade fever. I haven't read anything about E.Coli having fever.
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| hgheith
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Threre is a nice chart in step up to medicine with some of the bugs and what they produce.
Fecal Leukocytes present in:
Salmonella, Shigella, C.Jejuni, and E.Coli 0157:H7
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| neuroblastoma
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thanks hgheith
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