28-Year-Old Man With Nausea, Vomiting, and Diarrhea

Nicolas Grundmann, MD, MBA


June 10, 2015


Foodborne disease typically manifests as a mixture of nausea, vomiting, fever, abdominal pain, and diarrhea along with inflammation in the stomach (Figures 2 and 3). Acute gastroenteritis is a clinical diagnosis; laboratory tests and stool samples are not routinely required. Most pathogens are viral, and routine bacterial stool cultures reveal a pathogen in only 1%-10% of cases.[1] The vast majority of cases spontaneously resolve. The patient must stay hydrated. Treatment is symptomatic, except in cases of specifically identifiable pathogens. Stool samples should be considered in immunocompromised or pregnant patients and in those who have bloody diarrhea or chronic (> 14 days) diarrhea.

In developed countries, strict food-handling regulations and water sanitation systems dictate the etiology of disease. The exact incidence of this disease burden widely varies, depending on population, and is often underreported; patients infrequently seek medical care for mild cases.

The Centers for Disease Control and Prevention estimates that foodborne diseases account for approximately 8 million cases, 128,000 hospitalizations, and 3000 deaths each year in the United States.[2]

Although obtaining a food history is an important step in the diagnosis of gastroenteritis and foodborne pathogens, an exact source of contamination is often not discovered, even with careful history-taking. Depending on the type of pathogen causing the symptoms, the incubation period can range from 1 hour since ingestion (preformed toxins) to days or weeks (invasive pathogens).


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.