Table 71-5.

Cytotoxins Causing Food-borne Illness

Agent	Source	Incubation (hr)	Clinical Manifestations	Treatment
Salmonella	Beef, poultry, dairy, eggs, fish, reptiles	12–30	Abrupt onset of moderate to large amount of diarrhea becoming bloody ± abdominal pain or vomiting or low-grade fever	Intravenous cephalosporin if bacteremic, <3 mo of age, or immunosuppressed
Shigella	Potato, egg salad; lettuce, raw vegetables	12–30	Abrupt onset of bloody diarrhea, tenesmus, abdominal cramps lasting 3–7 days	Bactrim or ampicillin if severe disease, dysentery, or immunosuppressed
Campylobacter jejuni	Undercooked chicken or cattle	3–5 days	Foul-smelling, watery then bloody diarrhea ± abdominal cramps for 5–8 days, ± fever	Azithromycin or erythromycin (shortens duration of symptoms)
Yersinia enterocolitica	Contaminated pork or milk	4–6 days	Acute abdominal pain, fever, diarrhea	Bactrim or gentamycin (decreases duration of fecal excretion)
Escherichia coli O157:H7	Food or water contaminated with cow feces	3–5 days	Severe bloody diarrhea with painful abdominal cramps and low-grade fever; hemolytic-uremic syndrome in 3%–5%	Supportive
Entamoeba histolytica	Contaminated food or water	12–24	Sudden onset of bloody diarrhea with vomiting or abdominal cramps possibly lasting for more than a week	Metronidazole