Stool Leukocytes

Aka: Stool Leukocytes, Fecal Leukocytes

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II. Indications

  1. Acute Diarrhea

III. Technique

  1. Add 1 drop saline to stool
  2. Stains
    1. Wright stain
    2. Methylene blue stains viable cell's nuclei

IV. Interpretation

  1. Numerous Fecal Leukocytes (suggests invasive inflammatory Bacterial Diarrhea)
    1. Shigella
    2. Campylobacter jejuni
    3. Escherichia coli
      1. Enteroinvasive E. coli (EIEC)
      2. Enterohemorrhagic E. coli (EHEC) or E. coli 0157:H7
  2. Variable Fecal Leukocytes
    1. Salmonella typhimurium (non-typhoid)
    2. Yersinia enterocolitica
    3. Vibrio parahaemolyticus
    4. Clostridium difficile
    5. Mycobacterium tuberculosis
    6. Aeromonas
    7. Plesiomonas shigelloides (Aeromonas shigelloides)
  3. Absent Fecal Leukocytes absent
    1. Salmonella
    2. Yersinia
    3. Aeromonas
    4. Escherichia coli
      1. Enterotoxigenic E. coli (ETEC)
      2. Enteroadherent E. coli (EAEC)
    5. Clostridium Dificile

V. Efficacy: For identifying a Bacterial Diarrhea

  1. Similar efficacy to occult blood stool test as a marker of Bacterial Diarrhea
  2. Test Sensitivity: 50-80%
  3. Test Specificity: 83%

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