A migrant farmworker presents with acute onset of severe abdominal pain, nausea, vomiting, diarrhea, and headache with difficulty concentrating. What condition might cause such symptoms?

• A. Appendicitis
• B. Bacterial gastroenteritis
• C. Pesticide poisoning
• D. Viral illness

Answer: (C)

Exposure to pesticides, especially organophosphates, in farmworkers can cause rapid, multisystem toxicity. These chemicals inhibit acetylcholinesterase, leading to an excess of acetylcholine that shows up as gastrointestinal distress (severe abdominal pain, nausea, vomiting, diarrhea) along with neurologic symptoms (headache, difficulty concentrating). The combination of acute GI symptoms with CNS changes in a migrant agricultural worker points to pesticide poisoning rather than a purely infectious process. In contrast, appendicitis typically presents with localized abdominal pain and fever, while bacterial or viral gastroenteritis usually lacks the CNS symptoms or occupational exposure context. Therefore pesticide poisoning best explains the presentation. If exposure is suspected, immediate medical evaluation is essential.