Case History 3

A 59 year old man presents with a one day history of fever, abdominal cramps and diarrhea. His symptoms began six hours after the onset of the "runs" in two of his grandchildren and their mother all of whom had been visiting from their dairy and poultry farm in Wisconsin. The day before becoming ill all had eaten a meal consisting of Caesar salad, pasta with stir fried vegetables, bread and apples.  Other than the abdominal pain and six unformed bowel movements which contained mucus, he had no complaints.

On examination the man appeared ill. Temperature was 39.3 C, pulse 100 and blood pressure 110/80 standing. He had no rash. The abdomen was tender in the periumbilical area.

Case 3 Questions

1.    What is the likely cause of this man's diarrhea?  Answer

2.    Do these organisms cause diarrhea by invasion or toxin production?  Describe what is known of the pathogenesis of diarrhea caused by these organisms?  Answer

3.    How did the members of the family become infected?  What is the usual route of infection with this pathogen?  Answer

4.    What is the preferred therapy of enteritis due to salmonella?  Answer

5.    What other clinical syndromes are described with salmonella infection?  Answer

6.    Given the present distribution systems for meat, poultry and dairy products in the United States,  what measures could be adopted to reduce the spread of salmonella infection?  Answer