08-15-2009, 10:41 AM
A 22-year-old man presents to the emergency department with a 24-hour history of 8 to 10 episodes of liquid stools without blood. There is associated diffuse abdominal cramping pain relieved by each bowel movement. The patient denies tenesmus. There is no similar problem in the past, and no one else in the family has this problem. The patient also denies recent travel. His pulse rate is 94/min, and blood pressure is 148/96 mm Hg. There is no orthostatic hypotension, and his temperature is 37 C (98.6 F). His abdomen is soft and nontender. What is the best initial approach to this patient?
(A) Admit for observation
(B) Stool for cultures, ova, and parasites, and complete blood-count chemistry
© Empiric antibiotic therapy with trimethoprim/sulfamethoxazole or ciprofloxacin
(D) Reassurance and oral fluids
(E) Flexible sigmoidoscopy with mucosal biopsies
(A) Admit for observation
(B) Stool for cultures, ova, and parasites, and complete blood-count chemistry
© Empiric antibiotic therapy with trimethoprim/sulfamethoxazole or ciprofloxacin
(D) Reassurance and oral fluids
(E) Flexible sigmoidoscopy with mucosal biopsies