Which pattern best describes the clinical disease caused by EPEC?

Which pattern best describes the clinical disease caused by EPEC?

• A. Acute hemorrhagic diarrhea with fever
• B. Severe dehydration with shock
• C. Watery and chronic diarrhea; post-weaning diarrhea in pigs (afebrile, inappetence, watery diarrhea, purple discoloration of skin 1-2 weeks after weaning)
• D. Respiratory signs

Answer: (C)

The key idea here is the pattern of disease caused by enteropathogenic E. coli (EPEC): it produces a non-inflammatory, watery diarrhea due to attaching and effacing lesions on the intestinal mucosa, leading to malabsorption rather than bloody inflammation. In pigs, this classic presentation is post-weaning diarrhea: afebrile, inappetent piglets with chronic or persistent watery stools that appear after weaning. This fits the scenario described—the diarrhea is watery and chronic and occurs in the post-weaning period in piglets, with little to no fever. Other patterns don’t fit as well. Acute hemorrhagic diarrhea with fever suggests invasive or inflammatory pathogens rather than the non-inflammatory EPEC process. Severe dehydration with shock points to moreAcute, severe enteric illness or systemic involvement, not the typical mild-to-moderate post-weaning diarrhea of EPEC. Respiratory signs indicate a different organ system and pathogen altogether.

The key idea here is the pattern of disease caused by enteropathogenic E. coli (EPEC): it produces a non-inflammatory, watery diarrhea due to attaching and effacing lesions on the intestinal mucosa, leading to malabsorption rather than bloody inflammation. In pigs, this classic presentation is post-weaning diarrhea: afebrile, inappetent piglets with chronic or persistent watery stools that appear after weaning. This fits the scenario described—the diarrhea is watery and chronic and occurs in the post-weaning period in piglets, with little to no fever.

Other patterns don’t fit as well. Acute hemorrhagic diarrhea with fever suggests invasive or inflammatory pathogens rather than the non-inflammatory EPEC process. Severe dehydration with shock points to moreAcute, severe enteric illness or systemic involvement, not the typical mild-to-moderate post-weaning diarrhea of EPEC. Respiratory signs indicate a different organ system and pathogen altogether.