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{{Escherichia coli  enteritis}}
{{Escherichia coli  enteritis}}
{{CMG}}
{{CMG}} {{AE}} {{YD}}; {{SSK}}
==Overview==
==Overview==
Diagnostic laboratory findings for ''E. coli enteritis'' usually include either [[stool culture]], [[ELISA]], or [[polymerase chain reaction]] (PCR). Other laboratory findings in ''E. coli'' enteritis are usually non-specific and may include increased [[white blood cell]] count and elevated inflammatory markers. Laboratory findings suggestive of [[dehydration]] may include relative [[polycythemia]], [[metabolic alkalosis]], elevated [[BUN]] and serum [[creatinine]] (suggestive of pre-renal acute kidney injury). When hospitalized, patients should also be monitored for laboratory findings that may suggest development of [[hemolytic uremic syndrome]], such as [[hemolytic anemia]], elevated serum [[creatinine]], and [[thrombocytopenia]].  
Identification of the causative [[Strain (biology)|strain]] is usually not necessary for [[diagnosis]] and treatment. [[Diagnosis|Diagnostic]] [[Medical laboratory|laboratory]] [[Test|tests]] for [[Escherichia coli enteritis|''E. coli'' enteritis]] usually include either [[stool culture]], [[ELISA]], or [[polymerase chain reaction|polymerase chain reaction (PCR)]]. Other [[Medical laboratory|laboratory]] findings in [[Escherichia coli enteritis|''E. coli'' enteritis]] are usually non-specific and may include increased [[white blood cell]] count and elevated [[Inflammation|inflammatory]] markers. [[Medical laboratory|Laboratory]] findings suggestive of [[dehydration]] may include [[polycythemia|relative polycythemia]], [[metabolic alkalosis]], elevated [[BUN]] and [[serum]] [[creatinine]] (suggestive of pre-renal [[acute kidney injury]]). When [[Hospitalization|hospitalized]], [[Patient|patients]] should also be monitored for [[Medical laboratory|laboratory]] findings that may suggest the development of [[hemolytic uremic syndrome]], such as [[hemolytic anemia]], elevated [[serum]] [[creatinine]], and [[thrombocytopenia]].
 
==Laboratory Findings==
==Laboratory Findings==
===Diagnostic Laboratory Findings===
===Diagnostic Laboratory Findings===
*'''Stool cultures'''
*'''Stool cultures'''
:*Usually considered a reliable diagnostic test with good sensitivity since ''E. coli'' organisms typically shed continuously
:*Usually considered a reliable [[Diagnosis|diagnostic]] [[test]] with good [[Sensitivity (tests)|sensitivity]] since ''[[Escherichia coli|E. coli]]'' [[Organism|organisms]] typically shed continuously
:*Diagnosis of ''E. coli'' O157:H7 usually requires sorbitol-MacConkey agar
:*[[Diagnosis]] of ''[[Escherichia coli|E. coli]]'' O157:H7 usually requires [[sorbitol-MacConkey agar]]
*'''Serotyping'''
*'''Serotyping'''
:*ELISA detects Shiga-like toxins 1 and 2 in stools
:*[[Enzyme linked immunosorbent assay (ELISA)|ELISA]] detects [[Shiga-like toxin|Shiga-like toxins]] 1 and 2 in [[Human feces|stools]]
:*ELISA may detect anti-LPS IgM antibodies against some ''E. coli'' strains
:*[[Enzyme linked immunosorbent assay (ELISA)|ELISA]] may detect anti-[[Lipopolysaccharide|LPS]] [[IgM|IgM antibodies]] against some ''[[Escherichia coli|E. coli]]'' [[Strain (biology)|strains]]
*'''Polymerase chain reaction (PCR)'''
*'''Polymerase chain reaction (PCR)'''
:*Detection of E. coli pathogens and Shiga-like toxin
:*Detection of [[Escherichia coli|E. coli]] [[Pathogen|pathogens]] and [[Shiga-like toxin]]
===Non-Diagnostic Laboratory Findings===
===Non-Diagnostic Laboratory Findings===
*Lab findings of ''E. coli enteritis'' are usually related to the degree of dehydration or development of complications. Lab findings include:
*[[Medical laboratory|Laboratory]] findings of ''[[Escherichia coli enteritis|E. coli enteritis]]'' are usually related to the degree of [[dehydration]] or development of [[Complication (medicine)|complications]]. [[Medical laboratory|Laboratory]] findings include:
:*[[WBC]] count may be normal or elevated
:*[[WBC]] count may be normal or elevated
:*Elevated concentration of inflammatory markers (e.g. [[CRP]] or [[ESR]])
:*Elevated concentration of [[Inflammation|inflammatory]] markers (e.g. [[CRP]] or [[ESR]])
:*Chloride-sensitive metabolic alkalosis and electrolyte derangement (commonly [[hypokalemia]])
:*[[Chloride]]-sensitive [[metabolic alkalosis]] and [[Electrolyte disturbance|electrolyte derangement (]]<nowiki/>commonly [[hypokalemia]])
:*Relative [[polycythemia]] in cases of dehydration or [[hemolytic anemia]] in cases of [[hemolytic uremic syndrome]]
:*[[polycythemia|Relative polycythemia]] in cases of [[dehydration]] or [[hemolytic anemia]] in cases of [[hemolytic uremic syndrome]]
:*Elevated concentration of [[BUN]]
:*Elevated concentration of [[BUN]]
:*Elevated creatinine is suggestive of pre-renal [[acute kidney injury]] in severe dehydration or onset of hemolytic uremic syndrome<br><br>
:*Elevated [[creatinine]] is suggestive of pre-renal [[acute kidney injury]] in severe [[dehydration]] or onset of [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]]<br><br>
To learn more about laboratory findings associated with hemolytic uremic syndrome (such as prolonged PT and PTT, hemolytic anemia, and thrombocytopenia) click [[Hemolytic-uremic syndrome laboratory findings|'''here''']].  
To learn more about [[Medical laboratory|laboratory]] findings associated with [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] (such as prolonged [[Prothrombin time|PT]] and [[Partial thromboplastin time|PTT]], [[hemolytic anemia]], and [[thrombocytopenia]]) click [[Hemolytic-uremic syndrome laboratory findings|'''here''']].
 
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Gastroenterology]]
[[Category:Foodborne illnesses]]
[[Category:Emergency medicine]]
[[Category:Bacterial diseases]]

Latest revision as of 00:18, 18 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

Identification of the causative strain is usually not necessary for diagnosis and treatment. Diagnostic laboratory tests for E. coli enteritis usually include either stool culture, ELISA, or polymerase chain reaction (PCR). Other laboratory findings in E. coli enteritis are usually non-specific and may include increased white blood cell count and elevated inflammatory markers. Laboratory findings suggestive of dehydration may include relative polycythemia, metabolic alkalosis, elevated BUN and serum creatinine (suggestive of pre-renal acute kidney injury). When hospitalized, patients should also be monitored for laboratory findings that may suggest the development of hemolytic uremic syndrome, such as hemolytic anemia, elevated serum creatinine, and thrombocytopenia.

Laboratory Findings

Diagnostic Laboratory Findings

  • Stool cultures
  • Serotyping
  • Polymerase chain reaction (PCR)

Non-Diagnostic Laboratory Findings

To learn more about laboratory findings associated with hemolytic uremic syndrome (such as prolonged PT and PTT, hemolytic anemia, and thrombocytopenia) click here.

References