With a multitude of etiologies, gastroenteritis is one of the most common illnesses treated by emergency physicians. Many of the parasitic, bacterial, and viral organisms responsible for gastroenteritis share a zoonotic source in addition to a human source. In the evaluation of patients with suspected gastroenteritis, information regarding travel history and animal exposure is extremely important. Occupational exposure to cattle, horses, poultry, sheep, swine, or reptiles and even exposure to a household pet can be significant in determining a zoonotic origin. Dogs in particular are well known to have a 40 percent carriage rate for Giardia lamblia and a 30 percent carriage rate for the bacterial enteropathogens Salmonella sp. and Yersinia sp.50
Zoonotic gastroenteritis often presents with fever, headache, and abdominal pain often localizing to the right lower quadrant. Patients may have diarrhea or constipation. Laboratory findings may consist of electrolyte and acid-base abnormalities if diarrhea is severe. Leukocytosis may be seen if an interstitial invasion has occurred, and eosinophilia is often a finding with intestinal parasitic infestation. Most cases of zoonotic gastroenteritis are self-limiting and require only fluid hydration. However, specific pathogens may require specific therapy (Table 145-6).
TABLE 145-6 Gastrointestinal Zoonotic Infections
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