Diarrhea associated with enlargement of Payer's patches in the small intestine, causing ulceration of the overlying mucosa, is most likely a manifestation of infection with
A. Shigella dysenteriae
B. Salmonella typhi
C. Entamoeba histolytica
D. Clostridium difficile
E. Vibrio cholerae
B
Enlargement of the lymphoid follicles in the Payer's patches and ulceration of the overlying mucosa are found typically in infections caused by Salmonella typhi. Shigella infection causes hyperemia of the colonic mucosa and focal ulceration. Intestinal amebiasis presents in the form of deep ulcers that have laterally undermined borders and are described as "flask-like." Clostridium difficile is the most common cause of pseudomembranous colitis. Vibrio cholerae causes secretory diarrhea without gross or microscopic changes in the intestinal mucosa.
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