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[Analysis of fecal mucus in children with prolonged and acute diarrhea]
Insights
The fecal leukocyte test can help diagnose diarrhea in children. It identifies inflammatory responses, aiding in identifying bacterial infections like E. coli and shigellosis.
Area of Science:
- Pediatric Gastroenterology
- Clinical Microbiology
- Infectious Diseases
Context:
- Diarrhea is a common childhood illness.
- Identifying the cause of diarrhea is crucial for effective treatment.
- Fecal leukocytes indicate intestinal inflammation.
Purpose:
- To evaluate the diagnostic utility of fecal leukocytes in children with diarrhea.
- To correlate fecal leukocyte presence and type with specific bacterial pathogens.
Summary:
- A study analyzed fecal mucus from 110 children with diarrhea.
- Fecal leukocytes were detected in 44 samples.
- Distinct patterns of leukocytes were observed in infections caused by E. coli 0119, shigellosis, and salmonellosis.
- Septicemia showed an increased monocyte count.
- Negative stool cultures with fecal leukocytes suggested unidentified invasive E. coli or residual inflammation.
Impact:
- The fecal leukocyte test demonstrated a 73% diagnostic prediction index.
- Routine use is recommended for children with acute or protracted diarrhea before antibiotic treatment.
- This test can guide diagnostic and therapeutic decisions in pediatric diarrhea.
Abstract:
The fecal mucus obtained from 110 samples in 50 children with diarrhea was studied. Leukocytes were present in 44 cases and 66 samples were negative. Patients with E. coli 0111 did not show fecal leukocytes in contrast with those with E. coli 0119. Patients with shigellosis showed fecal leukocytes of polymorphonuclear predominance, the same as patients with non-thyphoid salmonellosis. But when septicemia was present, either from salmonella or from other enterobacteria, there was a striking increase in percentage of mononuclears. Several patients with negative stool cultures showed fecal leukocytes of polymorphonuclear predominance which suggested residual inflammatory reaction or presence of bacteriologically unidentified invasive E. coli. The index of diagnostic prediction for this test was 73%. Its routine use is recommended in any child with acute or protracted diarrhea, before the initiation of antimicrobial treatment.