A 32-year-old woman was admitted with 4 days of bloody diarrhea, abdominal pain, leukocytosis, and fever following fast food consumption and use of methamphetamine. An abdominal CT scan revealed continuous colonic mural thickening from the cecum to the splenic flexure (Fig. 1). Stool cultures for bacteria, ova and parasites, and fecal leukocytes were negative. Her symptoms resolved with supportive care, and on the day of discharge, her partner presented with identical symptoms (Fig. 2). His stool cultures grew shiga toxin 2-producing E. coli, serogroup O157:H7 (STEC). Based on his positive stool culture and the presence of diffuse colitis on both scans, a final diagnosis of STEC was given to both patients.
WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.
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