Food poisoning management

Food poisoning, also called foodborne illness, is illness caused by eating contaminated food. Infectious organisms — including bacteria, viruses, and parasites — or their toxins are the most common causes of food poisoning. The incubation period for infections involving the small and large intestine is typically 1–3 days.

Clinical features

• Cyanosis

• Heart failure

Pathophysiology and classification

Food poisoning can be classified according to the site of intestinal involvement.

Large intestine infections

Infections of the large intestine or colon can cause bloody, mucousy diarrhea associated with crampy abdominal pain.

• Campylobacter spp. is a common cause of food-borne disease

• Shigella spp. contaminate food and water and cause dysentery (severe diarrhea often containing mucus and blood)

• Salmonella spp. infections often occur due to poorly cooked or poorly handled chicken and eggs. In immunocompromised patients, infection may become systemic and life-threatening

• Vibrio parahaemolyticus can contaminate saltwater shellfish and cause watery diarrhea

Small intestine infections

Diarrhea due to small bowel infection tends not to be bloody, but infections may affect both small and large intestines.

• Escherichia coli (enterotoxigenic) is the most common cause of traveler’s diarrhea and typically causes watery diarrhea without fever or blood

• Vibrio cholerae causes profuse “rice-water” diarrhea due to contaminated drinking water

• Viruses such as Norwalk virus, rotavirus, and adenovirus may cause diarrhea with fever, chills, headache, and vomiting

• Botulism (Clostridium botulinum toxin) may present with vomiting, mild diarrhea, numbness, weakness, and progressive paralysis

Pharmacological treatment

Adults

• 0.9% sodium chloride (IV/PO as appropriate) 30 mL every 30 minutes; not to exceed 8–10 doses

• Loratadine (PO) 10 mg 24 hourly

• Antibiotics based on suspected infection

Children (2–5 years)

• 0.9% sodium chloride 7.5–15 mL every 30 minutes; not to exceed 8–10 doses

• Loratadine (PO) 5 mg 24 hourly

• Antibiotics based on suspected infection