Clinical Presentation & Protocol
Patient Usually Complains Of
Patient is an immunocompromised individual presenting with acute onset of fever, myalgia, and gastrointestinal distress following the consumption of high-risk food items (e.g., deli meats, unpasteurized dairy). Symptoms include nausea, vomiting, and watery diarrhea. Patient reports recent onset of headache or neck stiffness, raising concern for systemic dissemination.
Clinical Examination Findings
General: Febrile, appears ill, signs of dehydration. HEENT: Nuchal rigidity present/absent, photophobia. Cardiovascular: Tachycardic, regular rhythm. Abdominal: Soft, non-distended, hyperactive bowel sounds, diffuse mild tenderness without rebound or guarding. Neurological: Alert and oriented, focal neurological deficits absent/present. Skin: No rashes noted.
Treatment Protocol
Initiate empiric intravenous antibiotic therapy with Ampicillin (2g IV q4h) plus Gentamicin (synergistic dosing) for 14-21 days. Adjust dosage based on renal function. Monitor CBC, electrolytes, and inflammatory markers. If CNS involvement is suspected, perform lumbar puncture and consider adding Ceftriaxone if alternative pathogens are suspected.