[Clinical and laboratory indicators of etiology of diarrhea]

Several clinical symptoms and laboratory findings from 352 pediatric patients, seen in the Emergency Room for acute diarrhea, were evaluated in order to develop a method to predict the bacterial etiology of the diarrhea. According to the microbiology findings, the patients were classified into two groups: proven bacterial diarrhea and diarrhea of another etiology. Among all clinical symptoms recorded, only the following were found to be useful for the prediction score: fever greater than 38 degrees C (8 points), fecal mucus (8 points), over fecal blood (6 points) and the presence of fecal leukocytes in a wet mount (7 points). An alternative score useful for outpatients was developed that does not include a score for the wet mount. When the fecal leukocyte score was included and a cutoff value of 20 points was assigned, a sensitivity of 74% and a specificity of 83% were obtained. When the score for the fecal leukocytes was excluded and a cutoff value of 13 points assigned a sensitivity of 84% and specificity of 59% were obtained. These rapid and simple scores may be useful methods for predicting acute bacterial diarrhea in children.