Infectious Disease
Case 7: A Patient in Hospital with Abdominal Pain and Diarrhoea
CASE
A 75‐year‐old man was admitted to hospital 1 week ago with cellulitis of his right leg. He was treated with a course of antibiotics and his leg was clinically improving. He is known to have hypertension and diabetes. Whilst on call you were asked to assess this gentleman. He complained of diarrhoea and abdominal pain and felt unwell. He passed five large bouts of brown/green watery stool over the last 12 hours. There was no evidence of blood in his stool.
On examination he had a temperature of 38°C, a heart rate of 100 beats/min and an arterial blood pressure of 105/80 mmHg. His respiratory rate was 18 breaths/min with an oxygen saturation of 98% on air. He had generalized abdominal tenderness but there was no evidence of peritonism.
His blood results were available to you:
Hb 13 g/L WCC 30 × 109/L(80% neutrophils) Platelets 240 × 109/L CRP 20 mg/L ESR 20 mm/h D‐dimer Elevated Na 138 mmol/L K 4.1 mmol/L Urea 12 mmol/L Creatinine 120 µmol/L LFTs Normal
QUESTION 1
Your score this session: 0 of 0
How is the diagnosis most likely to be established?