The evaluation of all patients should include a history for recent travel, foods eaten, antibiotic use, occupational exposures, infectious contacts, and sexual practices. Noninfectious causes of diarrhea include heavy metals, mushrooms, drugs,and IBD in the reproductive age woman. Mix 2 drops of methylene blue with stool and wait 2-3 minutes. The test is positive if 3 or more PMNs are present per high power field in four or more fields. Postpartum neonate should be treated if exposure to invasive disease is suspected.
Norwalk virus accounts for roughly one third of gastroenteritid epidemics.
Stool is negative. Self limiting to 48h ETEC Most common cause of traveler's diarrhea. Symptoms include watery diarrhea, cramps. Occasional low grade fever. Vomiting is uncommon.