Jamie was an undergraduate senior just trying to survive her last semester before graduation. She had...
Jamie was an undergraduate senior just trying to survive her last semester before graduation. She had an early dinner in the dining hall of her college in order to get a long night of studying in. It was about 24 hours later when she suddenly started feeling very nauseous and was experiencing abdominal cramps. She started vomiting and noticed that she also has a watery stool. When she finally couldn’t take it anymore, she went to the health clinic where she saw three other people there that she had dinner with last night. They all had similar symptoms and seemed just as miserable as she did. When the nurse came back with the results from her stool culture, it was noted that there was an absence of fecal leukocytes and occult blood. Jamie begged the nurse to help her get rid of the body aches and vomiting, saying she had a Micro test the next day. Jamie asked for some amoxicillin but the nurse insisted that would not be a good idea.
1) What is your diagnosis for this patient?
2) On what do you base this diagnosis?
3)What secondary infection problems should be monitored?
4) Suggested treatment for this patient?
Homework Answers
1) The patient complaints of vomiting,watery stools accompanied by abdominal cramps. But the stool culture shows absence of fecal leukocytes and occult blood. This indicates the signs are related to non bacterial causes like viral or parasitic. The differential diagnosis in this case is Giardiasis.
2) It commonly spreads through food and person to person contact. The three other people there that she had dinner with last night. They all had similar symptoms and seemed just as miserable as she did.This statement indicate an epidemic of infection due to consumption of contaminated food or water.
3) Secondary infection problems like dehydration and hypovolemic shock should be monitored. Watery stools accompanied by vomiting will end up with lethal complications.
4) The suggested treatment includes broad spectrum antibiotics Metronidazole,nitazoxanide/Tinidazole. Treating underlying pain with analgesic and treating dehydration with administration of oral fluids and intravenous fluids like Normal saline,Dextrose normal saline and electrolyte replacement.
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