Jama 1994;271:1074

Cause:Bacillus cereus

Pathophys:Heat-stable toxin produced in unrefrigerated rice: stays when fried and causes N⁺V; perhaps an enterotoxin causing the diarrhea

Commonly reported in Europe, rare in US

Sx:

N+V: h/o eating fried rice; 1-6 h incubation

Diarrhea: 6- to 24-h incubation

Si:No fever; NV+D

24- to 36-h duration

Fulminant liver failure and rhabdomyolysis (Nejm 1997;336:1142).

If diarrhea, r/o clostridial and staph toxin colitis, which also lack fever

Lab:Bact: gram-pos rods

Rx:Symptomatic