DuPont HL. Acute infectious diarrhea in immunocompetent adults. N Engl J Med. 2014 Apr 17;370(16):1532-40. doi: 10.1056/NEJMra1301069. Review. PubMed PMID: 24738670.
Definition, Etiology, PathogenesisTop
Food poisoning refers to signs and symptoms caused by consumption of food contaminated with bacteria or bacterial toxins. It may be also caused by certain parasites and chemicals.
1. Etiologic agents: Predominantly Salmonella spp and Campylobacter spp or bacterial exotoxins (produced by Staphylococcus aureus, rarely by Clostridium perfringens, Bacillus cereus, Clostridium botulinum [see Botulism]).
2. Risk factors: Consumption of boiled and fried rice, boiled beef, grilled chicken (B cereus); creams (S aureus, B cereus); pastries and cakes (including ice cream and cakes filled with cream), milk and dairy products (S aureus, Salmonella spp, Yersinia enterocolitica, Escherichia coli, Listeria monocytogenes, Campylobacter spp, Shigella spp); chocolate (Y enterocolitica); pork, ham (S aureus, Y enterocolitica, Salmonella spp); raw or undercooked beef (E coli [particularly strain O157:H7], Campylobacter spp, L monocytogenes, C perfringens); turkey, chicken (Salmonella spp, Campylobacter spp, L monocytogenes, C perfringens); raw vegetables (L monocytogenes); salads (E coli, Shigella spp); raw eggs, raw or undercooked meat (Salmonella spp).
3. Incubation period ranges from a few hours (eg, S aureus, B cereus, L monocytogenes, E coli) to a few days (eg, Campylobacter spp, Yersinia spp).
Signs and symptoms have a sudden onset and include nausea, vomiting, and diarrhea (usually of moderate intensity, may contain blood). Other symptoms may include asthenia, abdominal cramping, fever, and malaise. The patient’s history indicates consumption of contaminated food, attending a social event/gathering with catering, or cases of diarrhea among other individuals who consumed the same foods. The diarrhea is usually short-lasting, resolves spontaneously, and in the majority of cases is associated with a good prognosis. See also Botulism.
Diagnosis is confirmed upon isolating a pathogen from a stool sample or a toxin from a suspected food sample (see Botulism).
Treatment and PreventionTop
Treatment and prevention are the same as in acute infectious diarrhea. Notification of appropriate epidemiologic authorities and securing samples of the suspicious food for testing may be mandatory.