Which feature best describes noninvasive secretory diarrhea?

• A. Vomiting and watery stools with no fecal leukocytes
• B. Fever with fecal leukocytes
• C. Presence of fecal leukocytes and blood
• D. Bloody stool

Answer: (A)

Noninvasive secretory diarrhea occurs when enterotoxins stimulate secretion in the gut without damaging the mucosa, so stools become large in volume and very watery while little inflammatory response occurs. That means you typically see watery diarrhea with minimal or no blood and, importantly, no fecal leukocytes. Vomiting is also common with toxin-mediated diarrhea. Fever and fecal leukocytes point to inflammatory or invasive infection with mucosal invasion, and the presence of blood or leukocytes in stool indicates inflammation or injury of the intestinal lining. Therefore, vomiting with watery stools and no fecal leukocytes best describes noninvasive secretory diarrhea.