CASE 47
A 25-year-old man presented to a hospital clinic with a 2-week history of sustained diarrhea (three to five bowel movements per day), nausea, flatulence, and lack of appetite. He described his diarrhea as initially watery, and then greasy and foul smelling. He added that he had a bloating sensation. He did not have fever or chills.
LABORATORY STUDIES
Diagnostic Work-Up
Table 47-1 lists the likely causes of illness (differential diagnosis). History and physical examination do not contribute to microbiologic diagnosis. Investigational approach may include
TABLE 47-1 Differential Diagnosis and Rationale for Inclusion (consideration)
Rationale: Diarrhea is a very common clinical symptom, and history alone is usually not sufficient to narrow an etiology. Epidemiology is often useful, such as travel to highly endemic areas. Noninfectious etiologies are also possible, but are considered only after other causes are excluded. However, prolonged diarrhea, foul-smelling stools, and flatulence are particularly associated with a protozoal agent.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
