ABSTRACT
A 40-year-old man presented to the emergency department following a collapse at home. He had a 4-day history of cramping abdominal pain and severe diarrhoea, opening his bowels 20–30 times per day and passing watery stool without blood or mucus. He had eaten at a Chinese restaurant several hours prior to his diarrhoea commencing, but the people he dined and shared food with were all well. He denied symptoms of fevers, cough or recent weight loss. He described passing reduced volumes of urine over the preceding 3 days, culminating in no urine output in the last 12 hours. His past medical history included a longstanding anaemia of unknown cause. He took no regular medications and was allergic to penicillin (unknown reaction). He lived alone and worked as a barrister. He denied both smoking and drinking excess alcohol, and did not use recreational drugs. He informed the team that he was penicillin-allergic. He stated that he had multiple male and female sexual partners most weekends and always used barrier contraception. He led an active lifestyle, taking part in a kickboxing class twice weekly and had last travelled abroad 3 months earlier when he visited Canada.
