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Gastrointestinal Infection 1

Gastrointestinal infection


Vignette: A 45-year-old woman presents to the emergency room with severe abdominal pain, nausea, and diarrhea. She mentions that she recently returned from a vacation in Mexico. Her temperature is 38.5°C, blood pressure is 110/70 mmHg, pulse is 105/min, and respirations are 18/min. Physical examination reveals diffuse abdominal tenderness. Stool cultures are negative. A stool sample is sent for microscopy and a cyst with four nuclei is observed. What is the most likely causative agent?


A. Giardia lamblia

B. Entamoeba histolytica

C. Cryptosporidium parvum

D. Trichomonas vaginalis

E. Plasmodium vivax


B. Entamoeba histolytica


This patient's recent travel to Mexico, along with her symptoms of abdominal pain, nausea, and diarrhea, suggest a diagnosis of amebiasis, which is most commonly caused by Entamoeba histolytica. This protozoan is transmitted via the fecal-oral route, often through contaminated food or water in developing countries. The cyst form of E. histolytica, which is seen in this patient's stool, is characterized by its four nuclei. giardia lamblia also forms cysts and can cause similar gastrointestinal symptoms, but its cysts typically contain two nuclei. cryptosporidium parvum can cause self-limited diarrhea in immunocompetent hosts, but is more commonly associated with persistent diarrhea in immunocompromised individuals. trichomonas vaginalis is a sexually transmitted protozoan that causes vaginitis in women. Plasmodium vivax is responsible for a type of malaria and is not typically associated with gastrointestinal symptoms.


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