Value of examination for fecal leukocytes in the early diagnosis of shigellosis

Fecal specimens from 101 patients with diarrhea were cultured and also examined with methylene blue for leukocytes. Thirty-six patients had leukocytes in their stools and 29 had culture-proven shigellosis. The sensitivity of fecal leukocytes in shigellosis was 95% (19/20) when cup specimens were obt...

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Published inThe American journal of tropical medicine and hygiene Vol. 28; no. 6; p. 1031
Main Authors Korzeniowski, O M, Barada, F A, Rouse, J D, Guerrant, R L
Format Journal Article
LanguageEnglish
Published United States 01.11.1979
Subjects
Acute Disease
Adolescent
Adult
Aged
Child
Child, Preschool
Diagnosis, Differential
Dysentery, Bacillary - diagnosis
Dysentery, Bacillary - microbiology
Feces - cytology
Humans
Infant
Leukocyte Count
Middle Aged
Shigella - isolation & purification
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Summary:Fecal specimens from 101 patients with diarrhea were cultured and also examined with methylene blue for leukocytes. Thirty-six patients had leukocytes in their stools and 29 had culture-proven shigellosis. The sensitivity of fecal leukocytes in shigellosis was 95% (19/20) when cup specimens were obtained, and 44% (4/9) when swab or diaper specimens were examined. Only 45% of the patients with shigellosis who provided cup specimens had grossly bloody dysentery. Twelve other patients had fecal leukocytes but no demonstrable invasive bacterial pathogens. Methylene blue examination was useful in identifying motile trophozoites of Giardia lamblia and eggs or larvae of other heavy intestinal paraistic infections. Among patients with naturally-acquired acute diarrhea, methylene blue examination of stools for leukocytes is much more sensitive than examination for blood in predicting a positive culture for Shigella spp. It is also of value in detecting parasites.
ISSN:0002-9637
DOI:10.4269/ajtmh.1979.28.1031