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In yesterday’s "Weekly Medical Questions" column, we pushed the latest issue of NEJM Knowledge+ Question of the Week.
Young men have diarrhea for 3 days without blood in the stool, fever and abdominal pain.
What is the most likely cause? Today, we announce the answer.
Do you see the answer? Of course, answering right is not the goal, but mastering the essentials and expanding knowledge is the kingly way.
Answer: Enterotoxigenic Escherichia coli.
Key learning points: The patient returned from a poor country with watery diarrhea and no bloody stools.
The most common cause is enterotoxigenic Escherichia coli infection.
Diarrhea often lasts for several days.
Expansion of knowledge For people returning from Mexico and other poor regions of the world, the most common cause of diarrhea is enterotoxigenic Escherichia coli.
People become infected after eating contaminated food or water.
The incubation period is 2 to 3 days.
The patient has acute watery stools without bloody stools.
The duration of diarrhea is often ≤ 5 days; most patients can fully recover within 48 to 72 hours.
Antibiotic (fluoroquinolone or azithromycin) treatment can further shorten the course of the disease.
Shigella toxin-producing Escherichia coli and Shigella flexneri can cause systemic symptoms, fever, and obvious pus and blood in the stool (the bacteria secrete Shiga toxin, block the host's protein synthesis and cause host cell death).
Salmonella typhi causes typhoid fever, a systemic disease characterized by fever and abdominal pain.
Diarrhea is not a prominent symptom of the disease, and patients may even have intestinal obstruction.
The mechanism of food poisoning caused by Staphylococcus aureus is that the food is contaminated with heat-stable enterotoxin.
Because the toxin has been produced, the onset of illness is rapid (usually 2 to 6 hours after eating).
Symptoms include nausea and vomiting, but they resolve on their own within 6 to 12 hours.
【Weekly Medical Questions】will continue to be updated.
What do you want to see or learn? Please tell us through the comments and look forward to your precious comments and suggestions.
References 1.
DuPont HL.
Acute infectious diarrhea in immunocompetent adults.
N Engl J Med 2014 Apr 17; 370:1532.
2.
Shane AL et al.
2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea.
Clin Infect Dis 2017 Nov 29; 65:e45.
Copyright information.
This article was translated, written or commissioned by J-Med Medical Research and Education Group (J-Med) and the New England Journal of Medicine (NEJM).
.
The Chinese translation of the full text and the included diagrams are exclusively authorized by the NEJM Group.
If you need to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
cn.
Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal liabilities.
Young men have diarrhea for 3 days without blood in the stool, fever and abdominal pain.
What is the most likely cause? Today, we announce the answer.
Do you see the answer? Of course, answering right is not the goal, but mastering the essentials and expanding knowledge is the kingly way.
Answer: Enterotoxigenic Escherichia coli.
Key learning points: The patient returned from a poor country with watery diarrhea and no bloody stools.
The most common cause is enterotoxigenic Escherichia coli infection.
Diarrhea often lasts for several days.
Expansion of knowledge For people returning from Mexico and other poor regions of the world, the most common cause of diarrhea is enterotoxigenic Escherichia coli.
People become infected after eating contaminated food or water.
The incubation period is 2 to 3 days.
The patient has acute watery stools without bloody stools.
The duration of diarrhea is often ≤ 5 days; most patients can fully recover within 48 to 72 hours.
Antibiotic (fluoroquinolone or azithromycin) treatment can further shorten the course of the disease.
Shigella toxin-producing Escherichia coli and Shigella flexneri can cause systemic symptoms, fever, and obvious pus and blood in the stool (the bacteria secrete Shiga toxin, block the host's protein synthesis and cause host cell death).
Salmonella typhi causes typhoid fever, a systemic disease characterized by fever and abdominal pain.
Diarrhea is not a prominent symptom of the disease, and patients may even have intestinal obstruction.
The mechanism of food poisoning caused by Staphylococcus aureus is that the food is contaminated with heat-stable enterotoxin.
Because the toxin has been produced, the onset of illness is rapid (usually 2 to 6 hours after eating).
Symptoms include nausea and vomiting, but they resolve on their own within 6 to 12 hours.
【Weekly Medical Questions】will continue to be updated.
What do you want to see or learn? Please tell us through the comments and look forward to your precious comments and suggestions.
References 1.
DuPont HL.
Acute infectious diarrhea in immunocompetent adults.
N Engl J Med 2014 Apr 17; 370:1532.
2.
Shane AL et al.
2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea.
Clin Infect Dis 2017 Nov 29; 65:e45.
Copyright information.
This article was translated, written or commissioned by J-Med Medical Research and Education Group (J-Med) and the New England Journal of Medicine (NEJM).
.
The Chinese translation of the full text and the included diagrams are exclusively authorized by the NEJM Group.
If you need to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
cn.
Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal liabilities.