Case 020: Diarrhea

PATIENT PRESENTATION

Chief Complaint

“I keep needing to go the bathroom”

History of Present Illness

S.L. is a 24-year-old man seen at urgent care with complaints of diarrhea after a recent camping trip

Link to EMR

Student Work-Up

TARGETED QUESTIONS

1. What signs and symptoms of diarrhea does the patient have?

   Hint: See Diarrhea in PPP

2. What questions are important to ask when faced with a patient presenting like this patient case?

   Hint: See Diarrhea in PPP

3. Are the present signs and symptoms indicative of traveler’s diarrhea? Is antibiotic therapy needed?

   Hint: See Diarrhea in PPP

4. Should this patient be treated for dehydration?

   Hint: See Diarrhea in PPP

5. How might common treatments used to alleviate the diarrhea be counterproductive?

   Hint: See Diarrhea in PPP

FOLLOW-UP

One week later, a follow-up phone call to the patient informed him that the stool culture was positive. During the call, the patient indicated that the diarrhea had ended. He was reminded that the antibiotic given to him was sufficient to resolve the problem if he had taken it as directed. He assured the clinician that he had. He was advised to contact the office if any new symptoms occurred. What advice should be given to the patient about future travel?

Hint: See Outcome Evaluation in PPP