Patient Encounter 2

A 45-year-old Hispanic man with AIDS presents to the emergency department (ED) with fever, nausea, two episodes of vomiting, abdominal pain, and nonbloody diarrhea for 2 days. He reports that his diarrhea is improving, but he developed fever and chills a few hours before he came to the ED. Other history is noncontributory. His physical examination is positive for fever and diffuse abdominal pain. An abdominal ultrasound did not show any abnormal findings. Two sets of blood cultures were sent. He was admitted to the hospital.

What GIpathogen(s) do you suspect in this patient given that his blood cultures came back positive for nontyphoidal Salmonella?

What treatment do you recommend? Do any further tests need to be performed before you can decide on treatment recommendation? Are there any special considerations owing to this patient's HIV infection?

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