A 14-year-old girl is brought to the physician by her father because of fever, chills, abdominal pain, and profuse nonbloody diarrhea. Her symptoms began 1 week ago when she had several days of low-grade fever and constipation. She returned from Indonesia 2 weeks ago, where she spent the summer with her grandparents. Her temperature is 39.3°C (102.8°F). Examination shows diffuse abdominal tenderness and mild hepatosplenomegaly. Cultures of the stool yield gram-negative bacilli that are non-lactose fermenting and oxidase negative. Which of the following is the most likely complication associated with this patient's current infection?

Question

A 14-year-old girl is brought to the physician by her father because of fever, chills, abdominal pain, and profuse nonbloody diarrhea. Her symptoms began 1 week ago when she had several days of low-grade fever and constipation. She returned from Indonesia 2 weeks ago, where she spent the summer with her grandparents. Her temperature is 39.3°C (102.8°F). Examination shows diffuse abdominal tenderness and mild hepatosplenomegaly. Cultures of the stool yield gram-negative bacilli that are non-lactose fermenting and oxidase negative.  Which of the following is the most likely complication associated with this patient's current infection?

Quizplus · Accepted Answer

Eductional Objective: Nontyphoidal Salmonella is a leading cause of foodborne gastroenteritis.  Most cases are marked by 3-4 days of self-limited fever, nausea, vomiting, and watery diarrhea.  A minority of individuals develop subsequent invasive disease with spread to the long bones (osteomyelitis), vasculature (mycotic aneurysm), or heart (endocarditis).  Risk of invasion is greatest in those with sickle cell disease or impaired immunity or at the extremes of age.

A 14-Year-Old Girl Is Brought to the Physician by Her