A 46-Year-Old HIV-Positive Man Is Hospitalized with Fever, Cramping Abdominal

A 46-year-old HIV-positive man is hospitalized with fever, cramping abdominal pain, and watery diarrhea.  Evaluation shows high fever, hypotension, tachycardia, and lower abdominal distension and tenderness.  Abdominal x-ray reveals free intraperitoneal air, and the patient is taken for urgent exploratory laparotomy.  Operative findings include an erythematous and dilated colon.  A focus of bowel wall necrosis with perforation is resected.  Histopathologic analysis reveals acute inflammatory changes, epithelial necrosis, and a layer of denuded epithelium, fibrin, and inflammatory cells overlaying the mucosa.  Which of the following pathogens is most likely responsible for this patient's current condition?

A) Campylobacter jejuni
B) Clostridioides difficile
C) Salmonella typhi
D) Shigella flexneri
E) Vibrio cholerae

Correct Answer:

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