What to do after an 18-year-old consumes expired mayonnaise?

Management of Expired Mayonnaise Ingestion in an 18-Year-Old

Observation and oral rehydration therapy are the primary interventions needed after consumption of year-old expired mayonnaise, with monitoring for signs of foodborne illness. 1

Initial Assessment

• Evaluate for symptoms of foodborne illness:

  • Vomiting
  • Diarrhea (with or without blood)
  • Abdominal cramping
  • Fever
  • Signs of dehydration

• Check for signs of dehydration severity:

  • Mild to moderate: dry mucous membranes, dry tongue, furrowed tongue
  • Severe: confusion, non-fluent speech, extremity weakness 1

Management Algorithm

If Asymptomatic:

1. Reassure that many cases of expired food consumption do not result in illness
2. Advise to monitor for symptoms over the next 24-48 hours
3. Encourage increased fluid intake (8-10 large glasses of clear liquids daily) 1
4. Provide instructions for when to seek medical attention

If Mild Symptoms Develop:

1. Begin oral rehydration therapy:

   • Provide clear fluids or oral rehydration solution (ORS)
   • Administer 50-100 ml after each loose stool 1
   • Commercial ORS or homemade solution (3.5g salt, 2.5g baking soda, 1.5g potassium chloride, 20g glucose per liter of clean water) 1

2. Dietary recommendations:

   • Follow BRAT diet (Bananas, Rice, Applesauce, Toast) 2
   • Avoid foods high in simple sugars, fats, and spicy foods 1
   • Avoid dairy products temporarily 2

If Moderate to Severe Symptoms Develop:

1. Seek immediate medical attention if:

   • Persistent vomiting preventing fluid intake
   • High stool output
   • Bloody diarrhea
   • Signs of dehydration despite treatment
   • Lethargy or altered mental status 1

2. Medical intervention may include:

   • IV fluid resuscitation with isotonic fluids (0.9% saline) 1
   • Possible antiemetics like ondansetron to control vomiting 2, 3
   • Monitoring of electrolytes and vital signs 1

Special Considerations

• Mayonnaise contains eggs which can harbor Salmonella and other pathogens when expired 2, 4
• Commercial mayonnaise contains preservatives and acidifying agents that may reduce but not eliminate risk of pathogen growth
• Year-old expired mayonnaise has significantly higher risk of contamination than recently expired products

Prevention of Future Incidents

• Educate about proper food storage and expiration date importance 4
• Emphasize importance of checking expiration dates before consumption
• Advise on proper hand hygiene and food handling practices 1

When to Return for Medical Care

Return immediately if any of these warning signs develop:

• Inability to keep fluids down for 24 hours
• Diarrhea lasting more than 3 days
• Severe abdominal or rectal pain
• Fever above 38.5°C (101.5°F)
• Signs of dehydration (decreased urination, dry mouth, dizziness) 1, 4

Remember that most cases of foodborne illness are self-limiting, but proper hydration is essential to prevent complications from dehydration.