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Differential diagnosis of microbial foodborne disease

David WK Acheson, MD, FRCP
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


Most clinicians consider a foodborne illness when a patient presents with gastrointestinal symptoms including nausea, vomiting, abdominal pain, diarrhea and fever. However, patients with foodborne illness may present initially with other complaints such as neurologic symptoms (eg, headaches, paralysis or tingling), hepatitis, and renal failure.

Since foodborne illness is common and the presenting symptoms may be protean, it is important to develop a consistent clinical diagnostic and treatment approach to these patients. The possible public health implications in cases of suspected foodborne illness must also be addressed.

This topic focuses on foodborne illness attributable to microbial causes, although chemicals and other agents transmissible via food can also lead to clinical illness. With more than 200 known agents capable of transmission through food [1], there are no simple algorithms to diagnose foodborne illness. However, there are some key factors that will point the clinician in the right diagnostic direction. Three key questions will be reviewed here:

What are the probable microbial causes of foodborne disease?

How do time course and types of symptoms serve as clues?


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Literature review current through: Sep 2016. | This topic last updated: Apr 12, 2016.
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