Which infection is characterized by bloody diarrhea with abdominal tenderness and absence of fever?

Which infection is characterized by bloody diarrhea with abdominal tenderness and absence of fever?

• A. Salmonella infection
• B. Norovirus infection
• C. Enterohemorrhagic E. coli infection
• D. Rotavirus infection

Answer: (C)

Bloody diarrhea with abdominal tenderness but little or no fever is classic for enterohemorrhagic E. coli infection. This organism releases Shiga-like toxin that damages the colonic lining, causing hemorrhagic colitis with visible blood in the stool and crampy abdominal pain. Fever isn’t prominent because the illness is driven more by toxin-mediated mucosal injury than by a systemic inflammatory response. Exposure is often linked to undercooked ground beef or contaminated produce, and diagnosis is by stool testing for the organism or its toxin. Management is mainly supportive; antibiotics and antimotility agents are generally avoided because they can worsen the risk of complications like hemolytic-uremic syndrome. In contrast, the other infections listed typically cause fever and nonbloody or less obviously hemorrhagic diarrhea, and thus don’t fit this presentation as well.

Bloody diarrhea with abdominal tenderness but little or no fever is classic for enterohemorrhagic E. coli infection. This organism releases Shiga-like toxin that damages the colonic lining, causing hemorrhagic colitis with visible blood in the stool and crampy abdominal pain. Fever isn’t prominent because the illness is driven more by toxin-mediated mucosal injury than by a systemic inflammatory response. Exposure is often linked to undercooked ground beef or contaminated produce, and diagnosis is by stool testing for the organism or its toxin. Management is mainly supportive; antibiotics and antimotility agents are generally avoided because they can worsen the risk of complications like hemolytic-uremic syndrome. In contrast, the other infections listed typically cause fever and nonbloody or less obviously hemorrhagic diarrhea, and thus don’t fit this presentation as well.