Historical features:
(1) spread through a family or other intimate group within a few days
Clinical features:
(1) diarrhea, which initially is watery but later contains blood and mucus in the stool
(2) fever up to 106°F (41.1°C)
(3) systemic toxemia
(4) abdominal cramping with pain and tenderness
(5) fecal urgency and tenesmus
(6) painful rectal exam with inflamed rectal mucosa which may ulcerate
where:
• The initial watery diarrhea reflects early involvement of the small intestine.
• The patient may pass a relatively large number of stools of small volume (termed fractional stools).
Laboratory findings:
(1) large number of white blood cells in fecal smear
(2) positive stool culture
(3) variable white cell count with an increased number of band forms (left shift)
