A 19 yrs old Male student presented with epigastric pain ,nausea and vomitting .he said that his symptoms started one day ago.he has 10 stools in the past day in the past days and has noticed blood mixed in with the stool on several occasions. He usually eats at home but reports having eaten chicken in the cholage cafeteria three days ago .he has no history of gastrointestinal disease .on examination he has atempreture of 37.8 C and appears to be in apain .his abdomen has hyperactive bowel sounds and is difussely tender but with out rigidity ,rebound tenderness or guarding . A general surgeon is consulted and is considering the diagnose of acute appendicitis versus bacterial gastroenteritis possibly related to the chicken eaten .a stool sample tests positive for blood and fecal leukocytes . Stool culture are sent and are subsequently positive for pathologic organism A what is your differential diagnosis? B what organism is the likely etiology of this condition? C. What are the risk factors for the diagnose ? D approach the investigations to confirm diagnose? E enumerate the complications he can develop?
Acute appendicitis Acute enteritis Acute bacillary dysentery Acute amoebic typhlitis Causitive agent is shegella dysentarie. Complications Bleeding Perforation Acute peritonitis Bacteremia leading to septicemia Fluid and electrolytes imbalance Shock.
