Fast Five Quiz: Can You Answer These Challenging Primary Care Questions?

Stephen Soreff, MD; B.S. Anand, MD; Scott H. Sicherer, MD; William James, MD; Mary L. Windle, PharmD

Disclosures

March 13, 2017

A stool pH of 5.5 or below or the presence of reducing substances indicates carbohydrate intolerance. This is usually transient in nature.

Enteroinvasive infections of the large bowel cause leukocytes, predominantly neutrophils, to accumulate in the lumen and then shed into stool. Absence of fecal leukocytes does not eliminate the possibility of enteroinvasive organisms; however, the presence of fecal leukocytes eliminates consideration of enterotoxigenic Escherichia coli, Vibrio species, and viruses. Shigella characteristically causes marked bandemia with variable total WBC count.

Anti-listeriolysin O (ALLO) is positive during the convalescent phase of bacterial gastroenteritis and when invasive disease has occurred.

History of raw seafood ingestion or foreign travel should prompt additional screening for Vibrio and Plesiomonas species.

For more on the workup of bacterial gastroenteritis, read here.

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