A 32-Year-Old Man Comes to the Office for a Follow-Up

A 32-year-old man comes to the office for a follow-up appointment.  The patient recently returned from a 10-day trip to Honduras.  On the fifth day of his trip, he developed malaise, anorexia, and abdominal cramps, quickly followed by watery diarrhea.  The patient had 5 or 6 stools daily but no fever.  He took no medications and remained hydrated by drinking bottled water and soup.  The patient felt better after 2 days and has had no additional symptoms since.  He has no other medical conditions.  Vital signs are within normal limits and the physical examination shows no abnormalities.  Which of the following was most likely involved in producing this patient's gastrointestinal symptoms?

A) Bacterial endotoxin
B) Cholera-like enterotoxin
C) Intestinal mucosal invasion
D) Shiga-like toxin
E) "Stacked-brick" intestinal adhesion

Correct Answer:

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