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This condition is the result of bacterial interference of mucosal integrity. This may occur due to direct invasion, toxin release, or by adherence to and disruption of the enterocyte brush border. Some enteropathic E. coli operate by all three mechanisms, the genetic determinants of virulence being carried in chromosomes or plasmids. Fever is a common feature in bacterial gastroenteritis. This is particularly so in Shigella infection where pyrexial convulsions and marked meningism may precede overt enteric symptoms such as diarrhoea and vomiting.
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