Infectious colitis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]
Overview
Diagnostic laboratory tests to identify the pathogens causing infectious colitis may include stool examination (such as microscopy, culture and fecal leukocytes), blood culture, serology, and molecular tests such as polymerase chain reaction (PCR). Non specific laboratory findings in infectious colitis are also done and helpful to rule out development of complications.
Laboratory Findings
The table below displays nonspecific laboratory abnormalities associated with Infectious colitis, including:[1][2][3][4][5]
| Test | Findings |
|---|---|
| Complete Blood Count |
|
| Electrolytes |
|
| Inflammatory Markers | |
| Blood cultures |
|
| Urinalysis |
|
Stool Cultures
Stool cultures in adequate culture media, allow the correct identification of the pathogen responsible for infectious colitis. The organism should be isolated from fresh stool. The sample should be planted in different selective and nonselective culture agar media, such as:[6]
- Blood
- McConkey
- Bismuth sulfite
- Eosin-methylene blue
- Salmonella-Shigella
In cases where there is reduced number of pathogens, enrichment broths, such as tetrathionate or selenite, may be used prior to culture of bacteria.[7]
Fecal leukocytes may also be identified in the specimen.[8]
The identification of the organism allows specific treatment of the disease, as well as appropriate follow-up recommendations.[9][10]
This test is not routinely performed due to its high cost, when compared with the accuracy of the results. Results from fecal cultures are often delayed and show an elevated rate of false-negatives.[11]
Stool culture may remain positive for 4 to 5 weeks, and in rare cases (chronic) for more than 1 year.[12]
Laboratory findings of infectious colitis depending on the pathogen causing the infectious colitis as follows:
- Shigella spp.
- Campylobacter jejuni
- Clostridium difficile
- Escherichia coli
- Nontyphoidal Salmonella
- Entameoba histolytica
- Chlamydia trachomatis
- Cytomegalovirus
- Yersinia enterocolitica
References
- ↑ "Diarrhoea and Vomiting Caused by Gastroenteritis".
- ↑ Agarwal R, Afzalpurkar R, Fordtran JS (1994). "Pathophysiology of potassium absorption and secretion by the human intestine". Gastroenterology. 107 (2): 548–71. PMID 8039632.
- ↑ Wang F, Butler T, Rabbani GH, Jones PK (1986). "The acidosis of cholera. Contributions of hyperproteinemia, lactic acidemia, and hyperphosphatemia to an increased serum anion gap". N Engl J Med. 315 (25): 1591–5. doi:10.1056/NEJM198612183152506. PMID 3785323.
- ↑ Welbourne T, Weber M, Bank N (1972). "The effect of glutamine administration on urinary ammonium excretion in normal subjects and patients with renal disease". J Clin Invest. 51 (7): 1852–60. doi:10.1172/JCI106987. PMC 292333. PMID 4555786.
- ↑ Batlle DC, von Riotte A, Schlueter W (1987). "Urinary sodium in the evaluation of hyperchloremic metabolic acidosis". N Engl J Med. 316 (3): 140–4. doi:10.1056/NEJM198701153160305. PMID 3796685.
- ↑ "Salmonella".
- ↑ "Salmonella".
- ↑ Granville LA, Cernoch P, Land GA, Davis JR (2004). "Performance assessment of the fecal leukocyte test for inpatients". J Clin Microbiol. 42 (3): 1254–6. PMC 356889. PMID 15004086.
- ↑ 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.
- ↑ Longo, Dan (2012). Harrison's principles of internal medicine. New York: McGraw-Hill. ISBN 007174889X.
- ↑ 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.
- ↑ Thielman NM, Guerrant RL (2004). "Clinical practice. Acute infectious diarrhea". N Engl J Med. 350 (1): 38–47. doi:10.1056/NEJMcp031534. PMID 14702426.