History of Present Illness (HPI)
A 67 year old Caucasian male presents with the complaint of 7-8 episodes of watery non bloody diarrhea for the last 7 days. He also notes generalized abdominal discomfort and low grade fevers. He denies nausea, vomiting, recent sick contacts or travel. He endorsed taking Imodium for two days prior to presentation with improvement in diarrhea but worsening abdominal pain.
Past medical and surgical history include metastatic pancreatic neuroendocrine tumor s/p Whipple’s surgery 4 years prior and one prior episode of Clostridium difficile diarrhea treated with an outpatient course of oral vancomycin 8 months prior. Home medications include pancreatic enzyme supplementation and pantoprazole. He has no significant family history for gastrointestinal pathology and denied alcohol, tobacco or substance use. His past colonoscopy results were unavailable.
Click Here for the Physical Exam!
Case 10 Index: