Salmonellosis other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Jolanta Marszalek, M.D. [3]
Overview
Other Diagnostic Studies
Microscopic Examination
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 cultures are indicated.[1] Limitations of this test include:
- Smear must be obtained from a fresh specimen, preferably collected in a cup (sensitivity 95%) [2]
- The result is dependent on the experience of the operator
Stool Cultures
Stool cultures 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.[3]
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.[1]
Lactoferrin Testing
Some studies advocate the importance to test for fecal lactoferrin. This test is considered more sensitive than simple microscopic examination of PMN. The Lactoferrin Latex Agglutination (LFLA) is an in vitro test able to detect a highly sensitive leukocyte marker, indicative of the presence of PMN.[1]
Its cost and high rate of false-positives in breast-fed children, limit its application.[3][4][1][5]
Colonoscopy
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.[3]
References
- ↑ 1.0 1.1 1.2 1.3 Choi SW, Park CH, Silva TM, Zaenker EI, Guerrant RL (1996). "To culture or not to culture: fecal lactoferrin screening for inflammatory bacterial diarrhea". J Clin Microbiol. 34 (4): 928–32. PMC 228919. PMID 8815110.
- ↑ Korzeniowski OM, Barada FA, Rouse JD, Guerrant RL (1979). "Value of examination for fecal leukocytes in the early diagnosis of shigellosis". Am J Trop Med Hyg. 28 (6): 1031–5. PMID 507279.
- ↑ 3.0 3.1 3.2 Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV; et al. (2001). "Practice guidelines for the management of infectious diarrhea". Clin Infect Dis. 32 (3): 331–51. doi:10.1086/318514. PMID 11170940.
- ↑ Hines J, Nachamkin I (1996). "Effective use of the clinical microbiology laboratory for diagnosing diarrheal diseases". Clin Infect Dis. 23 (6): 1292–301. PMID 8953074.
- ↑ Miller JR, Barrett LJ, Kotloff K, Guerrant RL (1994). "A rapid test for infectious and inflammatory enteritis". Arch Intern Med. 154 (23): 2660–4. PMID 7993149.