GoodGirl
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My question is , are there PMN in the stool in EHEC dysentery ? Kaplan states , page 281 Microbiology book : '' Bloody diarrhea in the absence of fecal leukocytes is a good indicator of EHEC, damage is due to toxin activity, so does not promote inflammatory response.''
Contrary couple of question ( not-Kaplan) states + PMN in the stool in EHEC dysentery, and also eMedicine :
''With dysentery (EIEC, EHEC), the patient has fever, bloody diarrhea, and dehydration. Intestinal mucosa produce a significant inflammatory response. Clinically, patients present with fever and have blood and PMN leukocytes in their stool. The differential diagnosis includes shigellosis and amebic dysentery'' http://www.emedicine.com/med/topic734.htmUnfortunately they put EIEC and EHEC together,where I understand that EIEC has in the stools PMN.
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| paheli
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Hey, GG. I ain't no know-it-all person, esp not in Micro. But, my impression is that EHEC has PMN in the stool.
Perhaps Bactitech can help, if she's around. [Maybe you can send a PM, in case she misses this thread when she signs in.]
G'luck.
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| lakshya_0_7
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yes EHEC doesnt have neutrophils.....coz its toxin mediated, which causes endothelial injury......
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| Tiff
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lakshya_0_7 wrote:
yes EHEC doesnt have neutrophils.....coz its toxin mediated, which causes endothelial injury......
Agree EHEC doesn't have an inflammatory response. You have it stated correctly from Kaplan. Fecal leukocytes are NOT found.
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| paheli
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Is eMedicine wrong as compared to KLN?  Hmmm..
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| GoodGirl
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Thanks for contributions to my query. Paheli, nice to see you here. 
I opened 16 edition Harrison's principles of internal medicine, page 878. Gosh, that book has 2783 pages written in fine print !
Anyway, what I found is that :
"Colonization of the colon and perhaps the ileum results in symptoms
after an incubation period of 3 or 4 days. Colonic edema and an initial
secretory diarrhea may develop into the STEC syndrome’s hallmark
trait of grossly bloody diarrhea (detected by history or examination)
in >90% of cases. Significant abdominal pain and fecal leukocytes
are commonly present (70% of cases), but fever is usually absent. "
He reffers to [fon t=Times-Roman]enterohemorrhagic E. coli ( EHEC) as Shiga toxin producing E.coli. (STEC )
[/font]
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| GoodGirl
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The last sentence states : Harrisons book refers to enterohemorrhagic E.coli ( EHEC) as Shiga toxin producing E.coli. ( STEC).
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| GoodGirl
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Here is the attached page from Harrison.
Attached Files:
E.coli- Harrison's Principles.JPG (258 KB, 4 downloads)
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| bactitech
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Just for the record, fecal leukocytes are not a particularly good indicator. They ARE if they're there. If they are not, you can't infer a whole lot. WBC's break down in stools very quickly. I'm in charge of making our positive control slides. I have a heckuva time finding poop with them. I usually take some nasty sputum and mix it with some poop to make some decent positive controls because of the breakdown effect in stool.
http://jcm.asm.org/cgi/content/full/39/1/266
http://tinyurl.com/6jr6ou - this says that neutrophils are present with EHEC
http://www.clinlabnavigator.com/Tests/FecalLeukoc... - sensitivity only about 65-70%
Culturing the stool is the best. Please don't order WBC's on patients with rock hard stools like some docs do.
We do not culture for E. coli O157:H7 now. We do serological test for shigatoxins which include EC O157:H7 and other strains. This is what is recommended now by CDC.
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| paheli
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Thanks, bactitech.
I hope you're well, ma'am. I'm over at Step 2CK now!
[Sorry, GG, for hijacking.]
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Prepare as if you're the worst, Perform as if you're the best! As you dream, so you manifest. So, DREAM BIG!! When you face hardship, remember, God never gives you more than you can handle. Success is the best revenge! He's my boyf! And, yea, I'm lying...:-(
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| bactitech
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I am fine 
I have come to the conclusion that I cannot retire for at least six years yet, maybe more, so I'll hang out with you young kids for awhile. 
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