Foodborne Disease Cases Flashcards
Members of 5 families developed nausea and vomiting 2-3 hours after eating lunch at a municipal 4th of July picnic. Their symptoms resolved by the next day. The menu consisted of fried chicken, coleslaw, baked beans, deviled eggs, watermelon and coconut cream pie. What is the most likely causative agent? What foods were most likely implicated? Change one element of this case to implicate Bacillus cereus. Which type of B. cereus would fit, and why?
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A 55-year-old male physician, who has recently returned to the U.S. after working in a medical clinic overseas, presents to the ED with a 2-day history of voluminous, non-bloody, watery diarrhea, and severe thirst. On physical examination, he is noted to be afebrile and has a blood pressure of 90/60 mm Hg, and a pulse of 128/minute. See images. Mucus flecks are observed in the diarrheal fluid. Where might the physician have been working? What is the pathogenesis of the most likely disease?
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A 36-year-old woman developed watery diarrhea (5-6 stools daily) and abdominal cramping on the 3rd day of a Caribbean cruise. She admitted to enjoying a variety of local foods and cocktails when off the ship, against the advice of her friends, and was upset because no one else seemed to be ill. The next morning she saw the ship doctor. A methylene blue-stained stool smear was negative for leukocytes and red blood cells. Her illness resolved before the end of her week-long vacation. What is a key virulence factor of the most likely causative agent?
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A 30-year-old man was hospitalized for multiple lacerations and fractures after a motorcycle accident. His wounds became infected, and he was treated with an intravenous third-generation cephalosporin. Five days after initiation of antibiotic therapy, the patient developed frequent, loose, watery stools. On physical examination he was found to be febrile and have mild abdominal tenderness. A CBC revealed a total WBC count of 17,600/μL. Enzyme immunoassay testing of stool filtrate for toxin(s) revealed the presence of toxins A and B. Since the cephalosporin could not be discontinued, oral metronidazole therapy was initiated. What are potential complications of this man’s diarrheal disease? Which is most likely?
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A 32-year-old man presents to the ED 24 hours after the sudden onset of increasingly severe right lower abdominal pain and fever. He notes that he was having difficulty passing stools, which were small and contained visible blood and mucus. Recently, he had returned from a sailing trip around Central America and the Caribbean. Fecal RBCs and WBCs are present. Stool culture grows colorless colonies on MacConkey agar and green colonies on Hektoen enteric agar, but blood cultures are negative. Colonoscopy revealed mucosal inflammation with erythema, edema, and multiple, friable ulcers. What is the appropriate treatment in this case?
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