Differential Diagnosis for Watery Bloody Diarrhea from Oysters and Sashimi

• Single most likely diagnosis:

  • Vibrio vulnificus and Vibrio parahaemolyticus: These bacteria are commonly associated with the consumption of undercooked or raw seafood, including oysters and sashimi. They can cause severe gastrointestinal symptoms, including watery bloody diarrhea.

• Other Likely diagnoses:

  • Salmonella: While more commonly associated with poultry and eggs, Salmonella can also be found in seafood and cause similar symptoms.
  • Escherichia coli (E. coli): Certain strains of E. coli, like E. coli O157:H7, can cause bloody diarrhea and are occasionally linked to seafood consumption, although this is less common.

• Do Not Miss diagnoses:

  • Vibrio cholerae: Although less common in many areas, Vibrio cholerae can cause severe, life-threatening diarrhea (cholera) and is associated with contaminated food or water, including potentially seafood.
  • Campylobacter: This bacterium is a common cause of diarrhea and can be found in undercooked seafood. It's crucial to consider due to its potential to cause severe disease, especially in immunocompromised individuals.

• Rare diagnoses:

  • Plesiomonas shigelloides: This bacterium can cause diarrhea and is occasionally linked to the consumption of contaminated seafood or water. However, it is less commonly identified as a cause compared to other pathogens.
  • Aeromonas hydrophila: While it can cause gastrointestinal disease, including diarrhea, its association with seafood consumption is less frequently highlighted compared to other pathogens listed here.