01493nam a2200241   4500001000800000005001700008007000300025008004100028040000800069041000800077100003000085245005600115300002300171520080000194650001200994650002901006650002301035650002401058650002001082700002201102700002401124773010301148ESSALUD20260804164633.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aAhonkhai, Aima A. eAutor  aCase 20-2026: A 38-year-old man with abdominal pain  apáginas: 291-300  a A 38-year-old man was evaluated at an outpatient clinic of this hospital because of abdominal pain. The patient had been in his usual state of good health until 6 weeks before the current presentation, when watery diarrhea (up to 20 episodes per day), accompanied by fever, chills, nausea, and vomiting, developed during a 3-week trip to rural Madagascar for work. Episodes of diarrhea started approximately 1 week after he arrived in Madagascar and lasted for 3 days, during which time he had limited food intake. The symptoms then gradually resolved, and he reported feeling well for 3 days afterward; however, the diarrhea then recurred. He received a single oral dose of levofloxacin, and the diarrhea resolved after 2 days. He returned to Massachusetts and then took a brief trip to Texas.  aALERGIA  aENFERMEDADES INFECCIOSAS  aMEDICINA CLÍNICA  aGASTROENTEROLOGÍA  aSALUD PÚBLICA  aHeller, Howard M.  aSchrader, Sarah M. 0 022717dMassachusetts NEJM GroupoNEJM003tThe New England Journal of Medicine wESSALUDx0028-4793