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| __NOTOC__
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| {{Salmonellosis}}
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| {{CMG}}; {{AE}} {{JS}} {{JM}}
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| ==Overview==
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| ==Other Diagnostic Studies==
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| ===Microscopic Examination===
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| The examination of stool samples, after staining with methylene blue, helps in the [[diagnosis]] of acute [[diarrhea]]. This test allows the identification of [[leukocytes]] in feces, suggesting an [[inflammatory]] etiology for the [[diarrhea]]. When the results indicate a serious form of the disease, further studies, such as [[stool culture]]s are indicated.<ref name="pmid8815110">{{cite journal| author=Choi SW, Park CH, Silva TM, Zaenker EI, Guerrant RL| title=To culture or not to culture: fecal lactoferrin screening for inflammatory bacterial diarrhea. | journal=J Clin Microbiol | year= 1996 | volume= 34 | issue= 4 | pages= 928-32 | pmid=8815110 | doi= | pmc=PMC228919 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8815110 }} </ref> Limitations of this test include:
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| *Smear must be obtained from a fresh specimen, preferably collected in a cup (sensitivity 95%) <ref name="pmid507279">{{cite journal| author=Korzeniowski OM, Barada FA, Rouse JD, Guerrant RL| title=Value of examination for fecal leukocytes in the early diagnosis of shigellosis. | journal=Am J Trop Med Hyg | year= 1979 | volume= 28 | issue= 6 | pages= 1031-5 | pmid=507279 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=507279 }} </ref>
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| *The result is dependent on the experience of the operator
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| ===Stool Cultures===
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| [[Stool culture]]s in adequate [[culture media]], allow the correct identification of the [[pathogen]] responsible for the [[infectious diarrhea]]. The identification of the organism allow specific treatment of the disease, as well as appropriate follow-up recommendations.<ref name="pmid11170940">{{cite journal| author=Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV et al.| title=Practice guidelines for the management of infectious diarrhea. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 3 | pages= 331-51 | pmid=11170940 | doi=10.1086/318514 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11170940 }} </ref>
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| However, this test is not routinely performed due to its elevated cost, when compared with the accuracy of the results. Often times results from fecal cultures are delayed and show an elevated rte of false-negatives.<ref name="pmid8815110">{{cite journal| author=Choi SW, Park CH, Silva TM, Zaenker EI, Guerrant RL| title=To culture or not to culture: fecal lactoferrin screening for inflammatory bacterial diarrhea. | journal=J Clin Microbiol | year= 1996 | volume= 34 | issue= 4 | pages= 928-32 | pmid=8815110 | doi= | pmc=PMC228919 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8815110 }} </ref>
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| ====Lactoferrin Testing====
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| Some studies advocate the importance to test for [[fecal]] [[lactoferrin]]. This test is considered more sensitive than simple microscopic examination of [[PMN]]. However, its cost and high rate of [[false-positive]]s in breast-fed children, limit its application.<ref name="pmid11170940">{{cite journal| author=Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV et al.| title=Practice guidelines for the management of infectious diarrhea. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 3 | pages= 331-51 | pmid=11170940 | doi=10.1086/318514 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11170940 }} </ref><ref name="pmid8953074">{{cite journal| author=Hines J, Nachamkin I| title=Effective use of the clinical microbiology laboratory for diagnosing diarrheal diseases. | journal=Clin Infect Dis | year= 1996 | volume= 23 | issue= 6 | pages= 1292-301 | pmid=8953074 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8953074 }} </ref><ref name="pmid8815110">{{cite journal| author=Choi SW, Park CH, Silva TM, Zaenker EI, Guerrant RL| title=To culture or not to culture: fecal lactoferrin screening for inflammatory bacterial diarrhea. | journal=J Clin Microbiol | year= 1996 | volume= 34 | issue= 4 | pages= 928-32 | pmid=8815110 | doi= | pmc=PMC228919 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8815110 }} </ref><ref name="pmid7993149">{{cite journal| author=Miller JR, Barrett LJ, Kotloff K, Guerrant RL| title=A rapid test for infectious and inflammatory enteritis. | journal=Arch Intern Med | year= 1994 | volume= 154 | issue= 23 | pages= 2660-4 | pmid=7993149 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7993149 }} </ref>
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| ===Colonoscopy===
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| For some cases of [[bloody diarrhea]] of unknown origin, a [[colonoscopy]] is indicated. It contributes to the [[diagnosis]] by confirming or ruling out conditions such as [[ulcerative colitis]] or [[malignancy]].<ref name="pmid11170940">{{cite journal| author=Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV et al.| title=Practice guidelines for the management of infectious diarrhea. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 3 | pages= 331-51 | pmid=11170940 | doi=10.1086/318514 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11170940 }} </ref>
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| ==References==
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| {{Reflist|2}}
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| [[Category:Bacterial diseases]]
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| [[Category:Foodborne illnesses]]
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| [[Category:Zoonoses]]
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| [[Category:Disease]]
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| [[Category:Infectious disease]]
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| [[Category:Emergency medicine]]
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| [[Category:Intensive care medicine]]
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