What is the role of stool studies in the emergent management of pediatric patients with fever?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Diarrhea in children is commonly caused by viral organisms and is usually not considered a major source of fever. However, diarrhea with blood or mucus is an indication for further testing for fecal leukocytes, which suggests invasive bacterial etiologies.

If fecal leukocytes (>5 per high-powered field) are present, a bacterial etiology is suggested and cultures are indicated. This finding may indicate infection with species of Salmonella, Campylobacter, Shigella, Yersinia, or toxic strains of Escherichia coli. The final diagnosis can be made only by obtaining stool cultures.

During winter months, children presenting with low-grade fever, vomiting, and diarrhea should be considered possibly infected with rotavirus. Children in day care centers are at increased risk for rotavirus infection. Rotavirus vaccine may change the incidence of this clinical etiology as well.

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