What is the initial approach to the workup for bacterial gastroenteritis?

Updated: Jul 17, 2018
  • Author: Jennifer Lynn Bonheur, MD; Chief Editor: BS Anand, MD  more...
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Answer

A stool pH of 5.5 or below or the presence of reducing substances indicates carbohydrate intolerance. This is usually transient in nature.

Enteroinvasive infections of the large bowel cause leukocytes, predominantly neutrophils, to accumulate in the lumen which are then shed into stool. The absence of fecal leukocytes does not eliminate the possibility of enteroinvasive organisms; however, the presence of fecal leukocytes eliminates consideration of enterotoxigenic E coli, Vibrio species, and viruses. Shigella characteristically causes marked bandemia with variable total white blood cell (WBC) count.

Examine any exudate found in the stool for leukocytes. Such exudates are highly suggestive of inflammatory bowel disease, which could be infectious or of another origin.

Antilisteriolysin O (ALLO) is positive during the convalescent phase of bacterial gastroenteritis and when invasive disease has occurred.

Commercially available multiplex molecular panels may be more sensitive and provide more rapid results (< 3 hours) than stool cultures, which are labor intensive and whose results may take longer than 1 day (66.5 hours). [21, 44]


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