In the past decade cholera has been seen in patients from Peru and the surrounding area. Isolated cases have been reported from Western Louisiana and Eastern Texas associated with steamed crabs. S. typhi is rare in the USA and usually presents with constipation and a low WBC count. Patients with typhoid may develop diarrhea and bleeding later in their course. Campylobacter jejuni may also cause dysentery and may simulate acute ulcerative colitis on sigmoidoscopy.
Ulcerative colitis is still a consideration if infectious causes are excluded.
Click here to return to Case Presentation, Questions and References 2. The most probable cause of this patient s dysentery is an infectious agent. While there may be a slight increase in stool fat in patients with diarrhea, the investigation in this case should be focused on the causes of infectious diarrhea. The stool should be checked for bacteria and other pathogens. Campylobacter jejuni is slower growing than the other bacteria under consideration, and requires special techniques for its culture, so the laboratory should be notified that Campylobacter is a consideration.