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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
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Gastrointestinal (GI) diagnostic studies are pivotal in confirming, ruling out, diagnosing, or staging various diseases, including cancers. Following diagnosis, allocating time for discussions with the patient and providing informational resources is crucial. Diagnostic assessments of the GI tract often occur in outpatient settings like endoscopy suites or GI labs. Preparation for these tests may include dietary restrictions, fasting, liquid bowel preparations, laxatives, enemas, and the...
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Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study.

Gillian A M Tarr1, Drew J Persson1, Phillip I Tarr2

  • 1Division of Environmental Health Sciences, School of Public Health, University of Minnesotagrid.17635.36, Minneapolis, Minnesota, USA.

Microbiology Spectrum
|September 20, 2022
PubMed
Summary
This summary is machine-generated.

Experts agree on priority testing for key bacterial and viral pathogens causing gastroenteritis in children. Immunocompromised children require additional testing for bacterial and parasitic targets to improve diagnostic stewardship.

Keywords:
acute gastroenteritisdecision supportdiagnostic stewardshipenteric pathogen

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Area of Science:

  • Clinical microbiology and infectious diseases.
  • Pediatric gastroenterology and public health.

Background:

  • Gastroenteritis diagnostics in children impact multiple stakeholders, including clinical care, disease control, and labs.
  • Advancing testing options necessitate understanding pathogen priorities for effective diagnostic stewardship.

Purpose of the Study:

  • To identify priority enteropathogens for testing in children with gastroenteritis.
  • To inform diagnostic stewardship strategies by aligning testing with clinical and public health needs.

Main Methods:

  • A modified Delphi technique was employed to survey subject matter experts.
  • Expert opinions were aggregated to determine consensus on testing priorities for various enteropathogens.

Main Results:

  • High agreement (≥80%) was reached on testing priorities for Campylobacter, Shiga toxin-producing E. coli, Salmonella, Shigella, Vibrio, Yersinia, norovirus, and rotavirus.
  • Immunocompromised children were identified as a special population needing additional testing for 3-4 bacterial and parasitic agents.
  • Viral pathogen identification, while not altering immediate clinical care, is crucial for public health surveillance.

Conclusions:

  • Diagnostic stewardship strategies, including clinician education and decision support tools, are vital for optimizing testing.
  • Multiplex testing with selective reporting can support clinical and public health testing priorities effectively.
  • Findings guide the development of targeted diagnostic approaches to avoid over-testing while ensuring essential pathogen detection.