Question

A 38 year old woman has had four weeks of watery, non-bloody diarrhea and cramping abdominal pain. She denies a history of similar symptoms, sick contacts, drinking unpurified water, and recent travel. There have been no changes to her diet, and she does not drink milk or eat dairy products. Current medications include esomeprazole and ibuprofen. She completed a course of amoxicillin/clavulanate for a sinus infection two months ago. On physical examination, she is afebrile. Bowel sounds are slightly hyperactive, and there is mild lower abdominal tenderness to palpation. Which of the following tests will most likely lead to the diagnosis in this patient?

A. Sudan stain for fecal fat
B. Microscopic examination of the stool for ova and parasites
C. D-xylose test
D. Barium upper gastrointestinal series
E. ELISA for C.difficile-associated toxins A and B

Answer 1

The ELISA for C.difficile-associated toxins A and B is most likely to lead to the diagnosis in a patient with chronic watery diarrhea and a history of recent antibiotic use.

Step-by-step explanation:

The appropriate diagnostic test for a 38 year old woman experiencing watery, non-bloody diarrhea and cramping abdominal pain is an ELISA for C.difficile-associated toxins A and B. Given that she has taken antibiotics, specifically amoxicillin/clavulanate, two months ago, she may be at an increased risk for Clostridioides difficile infection, which can result in diarrhea and abdominal pain. The patient's clinical history and symptoms do not strongly suggest other causes of diarrhea such as malabsorption, parasitic infections, or illnesses linked to diet. Therefore, among the provided options, the ELISA test for C. difficile is the most likely to lead to the correct diagnosis.