Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • diarrhea
  • nausea and vomiting

Other diagnostic factors

  • abdominal pain
  • bloating
  • fever
  • dehydration
  • blood or mucus in stool
  • profuse rice-water stool
  • reactive arthritis
  • skin rash
  • difficulty swallowing
  • diplopia
  • slurred speech
  • weakness
  • hepatobiliary disease
  • pulmonary symptoms
  • other intestinal features
  • manifestations of ectopic infection

Risk factors

  • older people, children, and pregnant women
  • chronic disease
  • recent hx of travel
  • immunocompromised state
  • hx of contact with cases of food poisoning
  • consumption of undercooked meat
  • consumption of raw seafood
  • consumption of homemade canned foods
  • consumption of unpasteurized soft cheeses
  • consumption of deli meats
  • consumption of unpasteurized milk or juice
  • consumption of raw eggs
  • improper food handling and storage
  • use of antacids

Diagnostic investigations

1st investigations to order

  • stool microscopy for WBC and RBC
  • stool culture
  • stool O+P
  • CBC with differential
  • basic metabolic panel
Full details

Investigations to consider

  • stool/serum botulinum toxin detection test
  • blood culture
  • amylase and lipase
  • LFTs
  • hepatitis A IgM antibodies
  • hepatitis E IgM antibodies
  • acute abdominal series
  • sigmoidoscopy/colonoscopy
  • esophagogastroduodenoscopy
  • biopsy
  • duodenal aspirate
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Gastroenterologist

Department of Gastroenterology

John Radcliffe Hospital

Oxford

UK

Disclosures

PA is a consultant for Abbvie and an advisor to Bresmed Health Solutions, and has received travel expenses from NPS Pharmaceuticals (now Shire).

Consultant Gastroenterologist

Department of Gastroenterology

John Radcliffe Hospital

Oxford

UK

Disclosures

SK declares that he has no competing interests.

Dr Philip Allan and Dr Satish Keshav would like to gratefully acknowledge Dr Michael Bennish, Dr Willem J.S. de Villiers, and Dr Houssam E. Mardini, the previous contributors to this monograph. MB has received funds, salary, and/or research funding greater than 6 figures USD. MB declares that he has no other competing interests. WJSDV and HEM declare that they have no competing interests.

Peer reviewers VIEW ALL

Professor of Clinical Microbiology

Austrian Agency for Health and Food Safety (AGES)

Vienna

Austria

Disclosures

FA declares that he has no competing interests.

Department Head

Naval Health Research Center

San Diego

CA

Disclosures

NCC declares that she has no competing interests.

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