25-Year-Old Man With Fever, Diarrhea, and Weight Loss

A 25-year-old male immigrant from Central America presented to the emergency department with fever, general abdominal discomfort, nausea, watery diarrhea (10 to 15 bowel movements daily), and a 9-kg weight loss of 1 month’s duration. He did not have headache, photophobia or phonophobia, vision changes, dysphagia or odynophagia, chest pain, dyspnea, bloody stool, rash, or arthralgias. He had immigrated to the United States 3 years previously and lived in both Florida and Minnesota. He worked as a migrant laborer on a tomato farm.