Seventy-seven consecutive children with acute diarrhea housed in a residential institution for the retarded had examination of their stools for white blood cells, using a methylene blue, wet-mount preparation. Two of 22 children (9%) with parasitic infection of the intestine and three of 38 children (8%) with nonspecific diarrhea had fecal leukocytes. All five patients with shigellosis had numerous leukocytes when their stools were examined before institution of antimicrobial therapy. The test was less predictable than culture after therapy was begun, since only five of 12 children (42%) with culture-proved shigellosis had leukocytes. The present study indicates that the fecal leukocyte examination will generally allow distinction of bacterial from parasitic and nonspecific causes if stools are examined before antimicrobial agents are administered.
Peirce JE, DuPont HL, Lewis KR. Acute Diarrhea in a Residential Institution for the RetardedUsefulness of Fecal Leukocyte Examination. Am J Dis Child. 1974;128(6):772–775. doi:10.1001/archpedi.1974.02110310020004