Table 71-4.

Enterotoxins Causing Food-borne Illness

Agent	Source	Incubation (hr)	Clinical Manifestations*	Treatment
Staphylococci	Improperly stored meats, bakery, dairy	2–6	Intense vomiting and watery diarrhea, abdominal cramps, low-grade fever	Supportive
Bacillus cereus	Contaminated grains, meats, vegetables	1–6	Intense vomiting, abdominal cramps	Supportive; vancomycin or ciprofloxacin if invasive
		8–16	Diarrhea and abdominal cramps
Clostridium perfringens	Inadequately cooked meats and poultry	8–20	Abdominal cramps and diarrhea; vomiting and fever are rare	Supportive
Vibrio cholerae	Contaminated water and food (shellfish)	8–24	Profuse “rice” watery diarrhea for 3–5 days without abdominal cramps or fever	Tetracycline or doxycycline (shortens duration of symptoms)
Vibrio parahaemolyticus	Raw or improperly cooked seafood	8–24	Profuse watery diarrhea for 3–5 days	Tetracycline or doxycycline (shortens duration of symptoms)
Enterotoxic Escherichia coli	Contaminated meats, cheese, salads	8–18	Watery diarrhea ± vomiting or abdominal cramping	Supportive
Giardia lamblia	Contaminated water	2–3 days	Mild bloody diarrhea ± abdominal cramping for possibly more than 1 wk, ± anorexia	Metronidazole

^*Clinical manifestations for less than 2 days unless noted.