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CASE EXEMPLAR: Patient With Diarrhea CD is a 72-year-old male who presents with a complaint of diarrhea. He had recently been hospitalized for confirmed COVID-19 and was released on broad-spectrum antibiotics for concomitant pneumonia. He left the hospital on oral medications 4 days ago and his diarrhea started 2 days ago. He also complains of nausea, pain in the abdomen, and a low-grade fever. He has not seen blood in the stool. His appetite is poor, and he is not urinating much. His cough has resolved. Past Medical History • Status post COVID-19 infection • Recent bacterial pneumonia, organism unknown • Coronary artery disease with a previous drug-eluting stent Medications • Lisinopril, 20 mg daily • Verapamil, 120 mg twice daily • Amoxicillin/clavulanate, 875 mg/125 mg twice daily • Multivitamin Physical Examination • Height: 70 inches; weight: 172 lb; blood pressure: 132/58; pulse: 90; respiration rate: 16; temperature: 100.4 °F • Well-developed, underweight man in no distress • Poor skin turgor • Lungs: Scattered rhonchi in bases • Heart: Regular rate and rhythm, grade II/VI systolic ejection murmur • Abdomen: Soft, hyperactive bowel sounds, diffuse mild tenderness without guarding or rebound, no masses • Rectal exam: Prostate 3+ enlarged, liquid stool, hemoccult positive Labs and Imaging • Complete blood count significant for leukocytosis: WBC 15.1 × 109/L, leukocytes 14,000 × 109/L • Sodium: 150 mEq/L • Potassium: 2.8 mEq/L • Chest x-ray: clear • Abdominal x-ray: Significant air in the GI tract; no ileus; no free air Discussion Questions What are the top three presumptive diagnoses for CD? 2. Why did CD develop diarrhea? 3. How should CD’s diarrhea be managed?

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