Patient is a 24 year-old Hispanic female, a residing in Minnesota. Date of birth is March 24, 1982. Her husband AM, who is a 28 year-old computer programmer, accompanies patient. Chief Complaint: “My abdomen is very painful. My stools are very watery and there’s blood in it. ” Medical History Previous activities prior to onset of pain: Patient states that she had been traveling and felt sick shortly after arriving home. She states that she mostly ate fast food such as hamburgers and sandwich while she was away. Her husband said his wife started to have diarrhea when she got home and has been sick for four days.
Physical Examination findings: General: 24 years old Hispanic female appears to be weak and in pain. Diagnostic tests: A stool culture was utilized to determine whether the patient is suffering from food poisoning caused by Escherichia coli. Vital Signs: Temperature: 99. 9 Blood pressure: 130/90 Heart Rate: 113 Respirations: 26 Escherichia Coli is a member of the bowel flora of humans (Bettelheim et al. 1994, p. 561). E. coli is a short, straight Gram-negative bacillus that is non-sporing (Sussman 1997, p. 4). The incubation period for the disease or the period from ingestion of E. coli to the showing of symptoms takes three to nine days.
Escherichia coli normally colonize the normal bowel flora of the human body. It is found in the lower intestines of warm-blooded animals, including humans (cited in Karch 2005, p. 2). One of the strains of E. coli is named E. coli O157:H7 that often causes acute hemorrhagic diarrhea and produces severe abdominal cramps. The patient is recommended to replace fluids and electrolytes due to loss of fluids secondary to bloody diarrhea. It has been known that antibiotics do not improve the course of food poisoning. A study has shown that antibiotic treatment may precipitate kidney complications (Walterspiel et al. 1992, p.
29). Majority of patients recover from food poisoning without antibiotics therapy. Thus, patient will be advised to undergo intravenous therapy and bed rest. Escherichia coli is transmitted through ingestion of uncooked meat especially beef, unpasteurized milk and juice, raw sprouts, and contact with infected live animals. E. coli can also be transmitted through contaminated waters such as swimming pools, lakes, or drinking inadequately chlorine-treated water. The patient’s case can be linked to ingestion of insufficiently cooked meat to kill E. coli o157:H7 thus caused infection in the form of food poison and diarrhea.
The disease can be prevented in several measures. Avoiding cross contamination of cooking foods, especially uncooked beef and other meats, can prevent the disease. Raw vegetables and fruits should be washed thoroughly and are sliced in a chopping board solely for fruits and vegetables. Don’t use the same chopping board for meats and vegetables or fruits to prevent cross contamination. Always wear disposable gloves when changing diapers of a child who has diarrhea. Avoid drinking and playing in not chlorinated water. Don’t allow children to swim or bath in the water with other persons who have signs of diarrhea.
Avoid touching or letting family members near pet farm animals. Advise family members to always wash their hands carefully after each bowel movement to reduce the spread of infection. Another prevention is to drink only pasteurized milk, juice, or cider. A strain of Escherichia coli that is a particular concern in healthcare today is the O157:H7 that can cause severe or fatal renal or neurological complications. Infections caused by this strain often results to hemorrhagic diarrhea, and can cause hemolytic-uremic syndrome and sudden kidney failure in elderly patients and young children.
Other diseases caused by Escherichia coli are gastroenteritis, urinary tract infections, and neonatal meningitis. The mode of transmission that led to the development of gastroenteritis is through the oral-fecal route. Its symptoms that last from 1 to 6 days include nausea and vomiting, diarrhea, fever, loss of appetite, abdominal pain, bloody stools, fainting and weakness. E. coli can also cause urinary infection when it enters the bladder or kidney and multiply in the urine. The symptoms of UTI include painful urination, burning and stinging feeling when urinating, chills, fever, and hematuria.
The treatment for gastroenteritis is usually fluid replacement therapy because E. coli is self-limiting. UTI, on the other hand, requires intensive antibiotic therapy to avoid the infection to reach the kidneys. References Sussman, M. (1997). Escherichia coli: mechanisms of virulence. Australia: Cambridge University Press. Karch H, Tarr P, Bielaszewska M. (2005). “Enterohaemorrhagic Escherichia coli in human medicine. ” Int J Med Microbiol 295 (6-7): 405–18. Walterspiel J. N. , Ashkenazi S. , Morrow A. L. , Cleary TG (1992). “Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I”. Infection 20 (1): 25–9.