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Diagnosis of Escherichiosis
Last reviewed: 23.04.2024
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Symptoms of Escherichia are similar to the clinical picture of other diarrheal infections. Therefore, the diagnosis of Escherichia is based on the use of bacteriological methods of investigation. Material (stool, vomit, stomach washings, blood, urine, liquor, bile) should be taken in the early days of the disease before prescribing etiotropic therapy to patients. Crops are produced on Wednesdays by Endo, Levin, Ploskrepov, and also on the enrichment environment of Muller.
Immunological diagnostics of Escherichiosis, namely RA, RIGA in paired sera, is also used, but they are not convincing, since false-positive results are possible due to antigenic similarity with other enterobacteria. These methods are used for retrospective diagnosis, especially during an outbreak.
A promising diagnostic method is PCR. Instrumental diagnosis of Escherichiosis (sigmoidoscopy, colonoscopy) is of little informative.
The diagnosis of escherichiosis is valid only with bacteriological confirmation.
[Differential diagnosis of Escherichiosis
Differential diagnosis of escherichiosis is carried out with other acute diarrheal infections: cholera, shigellosis, salmonellosis, campylobacteriosis, food poisoning of staphylococcal etiology and viral diarrhea: rotavirus, enterovirus, Norvolk-viral infection, etc.
Unlike the Escherichiosis. Cholera is characterized by the absence of intoxication, fever, pain syndrome, the presence of multiple vomiting, rapid development of dehydration of III-IV degree. Helps in the diagnosis of an epidemiological anamnesis - stay in endemic for the cholera regions.
Shigellosis, in contrast to the Escherichiosis, is characterized by a high fever, the pain is localized in the left ileal region. Palpate spasmodic, painful sigma. The chair is lean, in the form of a "rectal spitting".
Salmonellosis. In contrast to the Escherichiosis, is characterized by more severe intoxication, diffuse pain in the abdomen, painful palpation in the epigastric and peripump regions, rumbling. Characteristic offensive stool is greenish.
For food toxicinfection of staphylococcal etiology, unlike escherichiosis, acute, turbulent onset of the disease, short incubation period (30-60 min), more pronounced symptoms of intoxication, vomiting indomitable. Pain in the abdomen is cutting, with localization in the epigastric and peripump areas. Characterized by the group nature of the disease, the association of the disease with the food factor, the rapid regression of the disease.
Rotavirus gastroenteritis, unlike escherichiosis, is characterized by catarrhal phenomena, changes in the mucous membrane of the oropharynx (hyperemia, granularity), weakness, adynamia. Pain in the abdomen diffuse, the stool is liquid, "foamy", with a sharp, acidic smell, the urge to defecate is imperative. When palpation is noted, "large-caliber" rumbling in the region of the blind, rarely sigmoid colon.
Example of the formulation of the diagnosis
A04.0. Escherichiosis 018, a gastroenteric form of medium severity.