A 57-year-old, otherwise healthy cooking student presented to the emergency department with 4 days of nausea/vomiting, abdominal pain, and nonbloody diarrhea. Upon presentation, she was found to have high-grade fever (>39.0 °C), bibasilar pulmonary rales, and difiuse abdominal pain with voluntary guarding on abdominal examination. Blood tests showed a white blood cell count of 1900 cells per cubic millimeter (93.3 neutrophils, 6 lymphocytes, 0.5 monocytes, and 0.3 eosinophils). Blood chemistry showed hypokalemla (K~+ of 3.1 mmol/L) and mild renal insufficiency (creatinine of 1.58 mg/dL). The patient's oxygen saturation was 99 (on room air), and the result of the chest radiograph was normal (Fig. 3). An abdominal computed tomographic scan with contrast showed evidence of small bowel enteritis.
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