Internal Medicine

0521779407-07 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10

588 Food Poisoning

■Rehydration

■Correction of electrolyte disorders

■Avoidance of contaminated food/water

General Measures

■Obtain blood and stool studies prior to specific treatment

■Consider abdominal x-ray or endoscopy for further information

specific therapy

■Indicated for patients with moderate to severe diarrhea or complicat-

ing circumstances such as electrolyte disorders, dehydration, ane-

mia,

■cardiovascular instability etc.

■Antibiotics – specific for agent involved; most cases resolve within

12–24 hr and do not require antibiotics; consider empiric therapy for

patients with febrile dysentery

■Antitoxins – specific for agent involved (C. botulinum)

■Avoid antimotility and anti-emetic agents

■Side effects of antibiotic treatment

➣Worsening diarrhea

➣Allergic reactions

➣C. difficile colitis

■Prolonged fecal excretion of certain microorganisms

■Side effects of antimotility agents

➣Toxic megacolon

➣Perforation

➣Contraindicated in certain infectious conditions

■Side effects of anti-emetic agents

➣Further systemic absorption of toxin

follow-up

■During treatment or monitoring, assess potential complications

of therapy or worsening of disease requiring more aggressive

therapy

■Make attempts to recognize outbreak potential/epidemics

■Inform health department of outbreaks

■Patient education with proper handling, storage, selection and

preparation of food

complications and prognosis

Complications

■Electrolyte disorders – metabolic alkalosis (V. cholerae)

■Bacteremia (L. monocytogenes, Salmonella)