It’s commonly believed that food poisoning inevitably causes acute bouts of diarrhea and vomiting. But in the past few years, Marvin M. Lipman, Consumer Reports’ chief medical adviser, hospitalized two patients with this all-too-common affliction who had neither of those symptoms.

One of the men had a six-month history of intermittent fever, weight loss, night sweats and joint pain. The second was hospitalized with high fever, confusion and stiff neck.

On further examination and testing, both turned out to have food poisoning, an illness caused by contaminated food or water. Each year, according to estimates by the Centers for Disease Control and Prevention, about 1 in 6 Americans is sickened by a foodborne illness. Of those, 128,000 require hospitalization and 3,000 die.

Misconceptions and more

Symptoms do usually consist of varying combinations of nausea, vomiting, diarrhea, abdominal pain and fever. But many people may be unaware that food poisoning doesn’t always lead to gastrointestinal grief, as evidenced by the two very sick people described above.

Some other facts about food poisoning also seem to have evaded many of us. For example, the majority of those who responded to a 2016 Food and Drug Administration survey believe that restaurant meals are more likely than home meals to be the cause of foodborne ills.

It’s true that your health is in the hands of kitchen personnel when you’re dining at the local bistro. But food that’s poorly prepared or incorrectly stored at home can also make you sick.

Also, although 66 percent of the FDA survey respondents said they felt that it was “very likely” that chicken may harbor germs, only 6 percent said the same of vegetables. (In fact, both can.)

Good news: Most of those survey takers — 90 percent — reported cleaning cutting boards after using them or changing cutting boards after prepping raw meat, poultry or fish. But fewer than half said they scrubbed up after cracking raw eggs — notorious for containing salmonella organisms. The majority also said they wash chicken prior to cooking, which doesn’t eliminate bacteria and can contaminate other foods and surfaces.

When foodborne ills strike

A variety of organisms can cause food poisoning. The most common include norovirus (a highly contagious virus, known for infecting multiple people on cruise ships), salmonella (found in meat, poultry, eggs and produce), E. coli (one cause of traveler’s diarrhea), hepatitis A virus (common in raw shellfish), campylobacter (common in poultry) and listeria (found in delicatessen meats and soft cheeses). Some, such as botulinum and staphylococcus, produce a potent toxin that does the damage.

If you suspect food poisoning, adequate fluid ingestion is key to avoiding complications. Lipman usually advises fruit juices and canned chicken broth to replace the lost fluid and electrolytes (mostly sodium and potassium). Antibiotics are not usually needed, and anti-diarrhea meds such as loperamide (Imodium A-D and generic) and diphenoxylate with atropine (Lomotil and generic) do little to help and could hinder recovery.

Most cases of food poisoning end on their own within a week or so. See your doctor if symptoms last more than three days (24 hours for infants and seniors), if abdominal pain is severe or if you have an oral temperature higher than 101.5 degrees or signs of dehydration (weakness, increased thirst, decreased urine output, lightheadedness). Hospitalization might be needed for rehydration with intravenous fluids.

In rare instances, food poisoning can be fatal, as with botulism from improperly prepared at-home preserves. Symptoms such as confusion, dizziness, numbness and tingling, and double or blurry vision constitute an emergency and warrant immediate medical attention.

Good outcomes

As for Lipman’s patients with the unusual symptoms? The first had brucellosis, an uncommon foodborne disorder. While taking his medical history, the doctor learned that he was a devotee of unpasteurized milk, a source of the brucella organism. He responded to a combination of antibiotics given over an eight-week period. The second, a butcher, had listeria meningitis, a result of his failure to wash his hands or wear gloves when handling raw meat in his shop. Antibiotics saved his life.

Copyright 2017. Consumers Union of United States Inc.

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