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Role of faecal leucocytes in the diagnostic evaluation of acute diarrhoea
Insights
Faecal leucocyte examination helps identify invasive bacterial diarrhea in infants. This test can guide decisions on whether to perform stool cultures for accurate diagnosis.
Area of Science:
- Pediatrics
- Microbiology
- Clinical Diagnostics
Background:
- Acute diarrhea is a common pediatric illness.
- Identifying the cause of diarrhea is crucial for appropriate treatment.
Purpose of the Study:
- To evaluate the utility of fecal leucocyte examination in diagnosing acute diarrhea in infants.
- To correlate fecal leucocyte presence with specific enteropathogen infections.
Main Methods:
- Fecal samples from 400 infants with acute diarrhea and 40 healthy infants were analyzed.
- Fecal leucocyte examination was performed.
- Enteropathogen isolation and identification were conducted via stool culture.
Main Results:
- Enteropathogens were identified in 28.75% of cases, with Escherichia coli being the most common.
- An exudative response (presence of leucocytes) was associated with invasive pathogens like Salmonella, Shigella, and Enteroinvasive E. coli (EIEC).
- Minimal or no leucocytic response was observed in infections with Enteropathogenic E. coli (EPEC), Enterotoxigenic E. coli (ETEC), and in cases without identified enteropathogens.
Conclusions:
- Fecal leucocyte examination is a valuable tool for distinguishing invasive bacterial diarrhea from other causes in infants.
- The test can help clinicians decide when stool culture is most beneficial, optimizing diagnostic resources.
Abstract:
The value of faecal leucocyte examination was assessed in 400 infants with acute diarrhoea and 40 normal healthy infants. Enteropathogens were isolated from 28.75%. Escherichia coli was the commonest (16.5%) followed by Salmonella typhimurium (7%), Vibrio cholerae (3.25%) and Shigella flexneri (1.5%). Exudative response was observed in 57.1% of stools with Salmonella and 66.6% each with Shigella and E.I.E.C. infections. 81.3%, 89.5% and 87.7% of stools from which EPEC and ETEC and no enteropathogens respectively were isolated showed minimal or no Leucocytic response. The test is useful to recognise probable invasive bacterial diarrhoea and to decide the cases in which stool culture could be advantageous.