Which bacterial organisms produce preformed toxins that cause acute diarrhea?
Symptoms that occur rapidly (< 12 hours) after ingestion and include nausea, vomiting, or diarrhea are consistent with the ingestion of a preformed toxin. Some of these toxins are heat stable thus persist despite cooking of foods. The most common syndromes are caused by the (1) heat stable Staphylococcus aureus enterotoxin, (2) Bacillus cereus enterotoxins (often associated with rice), and (3) Clostridium perfringens (rewarmed meats such as ham). Symptoms are generally self-limited. Point source outbreaks with multiple cases associated with one recent meal is typical. Additionally, ciguatera and scombroid seafood poisoning, caused by heat-stable toxins from bioaccumulation and spoilage, respectively, are common and can present with diarrhea as part of their syndromes.