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The causes of infectious diarrhea in HSCT recipients are diverse and influenced by patient\u2010specific risk factors, the post\u2010transplant timeline, and local epidemiology. During the past decade, our understanding of diarrhea in HSCT has witnessed a transformative shift through the incorporation of gastrointestinal (GI) multiplex polymerase chain reaction (PCR) panels. However, the judicious application of these panels is imperative to avoid overtesting and prevent adverse outcomes. The challenge lies in distinguishing between the diverse causes of diarrhea, ascertaining the clinical significance of detected pathogens, and navigating the diagnostic uncertainty presented by several non\u2010infectious conditions such as mucositis, intestinal dysbiosis, and acute graft\u2010versus\u2010host disease (aGvHD), all of which mimic infection. This review examines the landscape of infectious diarrhea in the HSCT population, encompassing both established (e.g., <jats:italic>Cytomegalovirus<\/jats:italic>, <jats:italic>Clostridioides difficile<\/jats:italic>, and norovirus) and emerging pathogens (e.g., sapoviruses, astroviruses). We propose a multifaceted diagnostic algorithm that combines clinical assessment, risk stratification, and tailored utilization of molecular platforms. While multiplex GI panels present invaluable opportunities for rapid and comprehensive pathogen detection, their judicious use is pivotal in preserving diagnostic stewardship. Customization of diagnostic algorithms tailored to local epidemiology ensures optimal patient care and resource utilization.<\/jats:p>","DOI":"10.1111\/tid.14184","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T17:45:47Z","timestamp":1698860747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["How I approach diarrhea in hematological transplant patients: A practical tool"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-7137","authenticated-orcid":false,"given":"Natalia E.","family":"Castillo Almeida","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J.","family":"Cichon","sequence":"additional","affiliation":[{"name":"Department of Internal 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