Food Poisoning

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍gastrointestinal symptoms

Symptoms include:

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍diarrhea, ‍ episodes ‍per day, ‍

‍abdominal pain, ‍diffuse, ‍dull, ‍mild

‍abdominal cramps

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍muscle aches

‍fatigue

‍loss of appetite

‍dehydration signs



Worsening factors: ‍noneeating

Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍consumption of undercooked foods

‍improper food handling

‍contaminated water source

‍similar symptoms in close contacts

‍recent travel

no history of: ‍immunosuppression

no use of: ‍laxatives





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Breasts: ‍normal, ‍mass, ‍axillary adenopathy

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Anorectal: DRE ‍normal, prostate ‍normal, ‍blood, ‍mass, anus ‍

Skin: ‍rashlesions on ‍

Extremities: ‍warm, ‍dry, cap refill ‍< 3> 3 sec, pulses ‍intact, ‍edema ‍bilaterally, ‍

Neurologic: cranial nerves ‍intact, strength ‍intact 5/5, sensation ‍intact, reflexes ‍intact 2+, cerebellar function ‍intact, gait ‍steady

Mental status: ‍alert, ‍oriented, speech ‍clear, mood ‍normal, thought ‍organized, ‍suicidal ideation, judgment ‍good





ASSESSMENT:

‍Food poisoning ‍likelyconfirmed

DDx: food poisoning, bacterial gastroenteritis, viral gastroenteritis, parasitic infection, chemical poisoning, allergic reaction, medication side effects, inflammatory bowel disease, irritable bowel syndrome, celiac disease, lactose intolerance, appendicitis, pancreatitis, hepatitis, peptic ulcer disease, small bowel obstruction, ischemic colitis, diverticulitis





PLAN:

Investigations:

- Stools: ‍bacterial culture, ‍parasitic culture, ‍C. difficile toxin

- Blood work: ‍CBC, ‍electrolytes, ‍creatinine, ‍CRP, ‍LFTs

Treatments:

- ‍Antibiotics

- ‍Rehydration

- ‍Antiemetics

- Education on food safety

Further care:

- Referral to dietitian for dietary advice post-recovery

- Referral to gastroenterologist if symptoms persist for more than 7 days

- Referral to ER if severe abdominal pain, severe vomiting, or fever occurs

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as fever, blood in stools, or severe vomiting