Clinical pathology of foodborne diseases: Notes on the patient with foodborne gastrointestinal illness

The symptoms and signs in persons with food- or waterborne infections provi de clues to the nature of the infecting microbe. Proper treatment of the af fected individual, and protection of those exposed to the same source, is d ependent on time-honored methods of diagnosis: exposure history, and physic al examination. Laboratory testing may help to identify the responsible age nt. Spontaneous recovery is the most likely outcome once supportive measure s such as fluid and electrolyte replacement are addressed. Antibiotics are often unnecessary and may prolong fecal excretion of certain microorganisms . Ln immunosuppressed persons or those weakened by marginal nutrition, food borne infection can be more severe, mandating more specific therapy. Manage ment requires knowing the level of tissue invasion and organ infected by ea ch of the commonly encountered microbes. Some of the most life-threatening infections (cho]era, for example) are associated with no visible tissue inj ury, yet they have a profound impact on gut function. In contrast, salmonel losis and shigellosis can cause severe gut injury, and when foodborne infec tions extend beyond the confines of the gut, skilled care is essential. Exa mples are hemolytic uremic syndrome of Escherichia coli infections, or list eriosis, both of which require urgent attention. Long-term consequences of gut infections such as the paralytic Guillain-Barre syndrome following Camp ylobacter infections illustrates the long-term problems sometimes encounter ed. Because it is unlikely that all infectious agents will ever be removed from food and water in any country, sound medical intervention tailored to the extent of illness will be the mainstay of handling such illnesses.