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Given that diarrhea and not endotoxemia is one of the principal clinical consequences of infection with enteric toxigenic bacteria, which demonstrably affect tight junction function, one must differentiate the modest increase in paracellular permeability reported in inflammatory conditions with no known over acute clinical consequences from the marked increase in paracellular permeability induced by enteric exotoxins with consequent massive fluid and electrolyte secretion and diarrhea