Clinician Notes for Meeting

Case Summaries for Bloody Diarrhea Cases

Case #1

A 32 year old white woman with no underlying medical problems was brought to the E.R. by a friend because of severe abdominal pain and diarrhea. She woke up with abdominal cramps, and over a couple hours she developed severe pain and a fever. About one hour prior to coming in, she noted bright red blood coming in the toilet bowl. She lives with her husband; there are no kids or other people in the house. Her husband has been on a business trip for five days. Last night she had dinner at home. She had baked chicken that was bought fresh on her way home from work; she used no spices or gravy. She made a small salad with salad dressing that has been in the fridge for a few days. And she had steamed broccoli. She drank only water that she keeps in a filtered pitcher. She ate breakfast yesterday, but nothing else during the day. She hasn’t eaten out for the past several days. On physical exam, she has a low grade temperature and she has some sores in her mouth.Her abdomen is extremely tender, and her rectal exam confirms bright red blood. Stool specimen was sent to the lab, as was a swab from her mouth lesions.

Case #2

An 84 year old man is brought in by his daughter with mild abdominal pain. He denies fever, chills, nausea, vomiting. He is on medications for hypertension, which have not changed for 10 years. He has no other medical problems. He lives alone in an apartment. He has “meals on wheels” brought to his house mid-day, five days per week. On physical examination, he had normal vital signs. His abdomen was tender.He had bright red blood per rectum on examination.

Case #3

A 16 year old girl was brought into the E.R. with a complaint of abdominal pain. She has no medical problems and is on no medications. She was fine until a couple hours previously when she started to develop the pain. She moved her bowels the day before, but not today. She lives with her parents and has no siblings. They ate dinner out the night before at an Italian restaurant, and had breakfast at home this morning. No one else is sick.

Name	Age/gender	Time of Onset	Symptoms	Physical Exam	Others sick?
Case #1: C.R.	32/F	9 AM	Abd pain, bloody stool	Acute abdomen, BRBPR	No
Case #2: A.F.	84/M	3 PM	Abd pain	Acute abdomen, BRBPR	No
Case #3: P.D.	16/F	2 PM	Abdominal pain.	Tender abdomen; normal rectal examination	No