A 24-Year-Old Man Comes to the Emergency Department Due to Severe

A 24-year-old man comes to the emergency department due to severe nausea and vomiting 2 hours after a church picnic.  He ate chicken salad that had been sitting out in the sun.  The patient has no prior medical conditions.  Temperature is 37.2 C (98.9 F) , blood pressure is 126/84 mm Hg, and pulse is 86/min.  No abdominal tenderness is present, and bowel sounds are normal.  Blood cell counts and serum chemistry studies are within normal limits.  Symptoms improve significantly within several hours with supportive care.  Which of the following is the most likely cause of this patient's symptoms?

A) Bacterial exotoxin production in the gut
B) Bacterial invasion of the gut mucosa
C) Ingestion of preformed enterotoxin
D) Microbial attachment to the intestinal surface
E) Systemic absorption of luminal endotoxin

Correct Answer:

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