Flu-like illness - GI infections

Gastro Intestinal Infections

Dr Patsy Lill
Professor Emerita
University of South Carolina School of Medicine

Flu-like illness

A 26-year-old man presents with a history of a flu-like illness characterized by chills, diaphoresis, loss of appetite, muscle aches, a non-productive cough, and headache. He also noted some pink spots on his chest at that time but they didn’t itch and went away. He now feels even worse and is constipated. He has a temperature of 40.5 and there is mild hepatospenomegaly and bradycardia. He returned from Brazil 1 week before the onset of symptoms but he states that he was immunized for typhoid fever prior to his trip. Colonoscopy shows oval ulcers oriented in the direction of fecal flow. Below is an image of a similar case. Note the extreme number of monocytes in the submucosa of the intestine.

The MOST likely diagnosis

1. Typhoid fever
2. Entamoeba histolytica infection
3. Cholera
4. Yellow fever
5. pathogenic E. coli infection

ANSWER

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Pathology questions by Dr Patsy Lill