{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:25:59Z","timestamp":1773404759895,"version":"3.50.1"},"reference-count":22,"publisher":"BMJ","issue":"6383","license":[{"start":{"date-parts":[[1983,6,25]],"date-time":"1983-06-25T00:00:00Z","timestamp":425347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,6,25]]},"abstract":"<jats:p>Findings of stool examinations in 1593 patients with diarrhoea due to a single enteric pathogen--enterotoxigenic Escherichia coli rotavirus, Shigella, Campylobacter jejuni, Vibrio cholerae 0:1, Entamoeba histolytica, or Giardia lamblia--were reviewed to determine how well they predicted the agent associated with the diarrhoea. Specimens were examined visually for blood and mucus, tested for pH, and examined under a microscope for the presence of red and white blood cells, parasites, and stool fat. Although visible blood was more common in specimens from patients infected with Shigella (51%) and Ent histolytica (39%) than in those from patients infected with other agents (6%; p less than 0.01), patients infected with Shigella were most likely to have numerous faecal leucocytes (greater than 50\/high power field: 39% v 8% of all patients and 7% of patients infected with Ent histolytica, p less than 0.01 in both cases). Patients infected with enterotoxigenic E coli, rotavirus, V cholerae 0:1, or C jejuni had loose stools with fewer red or white cells. Patients infected with rotavirus and C jejuni were more likely to have acid stools with 3 to 4+ fat, but these findings were related to young age and breast feeding. Stool examination is most useful in establishing a diagnosis of dysentery and in helping to distinguish between patients infected with Shigella and Ent histolytica; it is of limited usefulness in discriminating between pathogens causing watery diarrhoea.<\/jats:p>","DOI":"10.1136\/bmj.286.6383.2037","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"2037-2040","source":"Crossref","is-referenced-by-count":46,"title":["Value of stool examination in patients with diarrhoea."],"prefix":"10.1136","volume":"286","author":[{"given":"B J","family":"Stoll","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R I","family":"Glass","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Banu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M I","family":"Huq","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M U","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1983,6,25]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Diarrhea as a global problem and the WHO programme for its control","volume-title":"enteric infections in children","author":"Barua, D.","year":"1981","unstructured":"Barua D. Diarrhea as a global problem and the WHO programme for its control. In: Holme T, Holmgren J, Merson MH, Mollby R, eds. Acute enteric infections in children. Amsterdam: Elsevier, 1981:1-6."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/ije\/9.1.25","article-title":"Epidemiology and causes of death among children in a rural area of Bangladesh","volume":"9","author":"Chen, L.C.; Rahman, M.; Sarder, A.M.","year":"1980","unstructured":"Chen LC, Rahman M, Sarder AM. Epidemiology and causes of death among children in a rural area of Bangladesh. Int Epidemiol 1980;9: 25-33.","journal-title":"Int Epidemiol"},{"key":"ref_3","first-page":"133","article-title":"Epidemiology of acute diarrheal diseases in children in Addis Ababa","volume-title":"enteric infections in children","author":"Habte, D.; Stintzing, G.; Thoren, A.; Mollby, R.","year":"1981","unstructured":"Habte D, Stintzing G, Thoren A, Mollby R. Epidemiology of acute diarrheal diseases in children in Addis Ababa. In: Holme T, Holmgren J, Merson MH, Mollby R, eds. Acute enteric infections in children. Amsterdam: Elsevier, 1981:133-9."},{"key":"ref_4","first-page":"1185","article-title":"Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh","volume":"285","author":"Stoll, B.J.; Glass, R.I.; Huq, M.I.; Khan, M.U.; Holt, J.E.; Banu, H.","year":"1982","unstructured":"Stoll BJ, Glass RI, Huq MI, Khan MU, Holt JE, Banu H. Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh. Br MedJ7 1982;285:1185-8."},{"key":"ref_5","article-title":"Oral rehydration therapy-recent advances","author":"Mahalanabis, D.; Merson, M.H.; Barua, D.","year":"1980","unstructured":"Mahalanabis D, Merson MH, Barua D. Oral rehydration therapy-recent advances. Geneva: World Health Organisation, 1980. (WHO document No WP\/05 1980.)"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1093\/infdis\/142.5.660","article-title":"A two-year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh","volume":"142","author":"Black, R.E.; Merson, M.H.; Rahman, A.S.M.M.","year":"1980","unstructured":"Black RE, Merson MH, Rahman ASMM, et al. A two-year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh. 7 Infect Dis 1980;142:660-4.","journal-title":"7 Infect Dis"},{"key":"ref_7","first-page":"362","article-title":"Identification of enterobacteriaceae","author":"Edwards, P.R.; Ewing, W.H.","year":"1972","unstructured":"Edwards PR, Ewing WH. Identification of enterobacteriaceae. 3rd ed. Minneapolis: Burgess Publishing, 1972:362.","edition":"3rd ed"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0140-6736(77)90951-5","article-title":"Enzyme-linked immunosorbent assay (ELISA) for detection of human reovirus-like agent of infantile gastroenteritis","volume":"ii:","author":"Yolken, R.H.; Kim, H.W.; Clem, T.","year":"1977","unstructured":"Yolken RH, Kim HW, Clem T, et al. Enzyme-linked immunosorbent assay (ELISA) for detection of human reovirus-like agent of infantile gastroenteritis. Lancet 1977;ii:263-6.","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/infdis\/125.4.407","article-title":"Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu","volume":"125","author":"Dean, A.G.; Ching, Y.C.; Williams, R.C.; Harden, L.B.","year":"1972","unstructured":"Dean AG, Ching YC, Williams RC, Harden LB. Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu. J Infect Dis 1972;125:407-1 1.","journal-title":"J Infect Dis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1128\/IAI.11.2.334-336.1975","article-title":"Test for enterotoxigenic Escherichia coli using Y, adrenal cells in miniculture","volume":"11","author":"Sack, D.A.; Sack, R.B.","year":"1975","unstructured":"Sack DA, Sack RB. Test for enterotoxigenic Escherichia coli using Y, adrenal cells in miniculture. Infect Immun 1975;11:334-6.","journal-title":"Infect Immun"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1128\/IAI.10.2.320-327.1974","article-title":"Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: a rapid, sensitive in vitro assay for the enterotoxins of Vibrio cholerae and Escherichia coli","volume":"10","author":"Guerrant, R.L.; Brunton, L.L.; Schnaitman, T.C.; Rebhun, L.I.; Gilman, A.G.","year":"1974","unstructured":"Guerrant RL, Brunton LL, Schnaitman TC, Rebhun LI, Gilman AG. Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: a rapid, sensitive in vitro assay for the enterotoxins of Vibrio cholerae and Escherichia coli. Infect Immun 1974;10: 320-7.","journal-title":"Infect Immun"},{"key":"ref_12","first-page":"427","article-title":"The faecal smear in the therapy of diarrhoeas","volume":"21","author":"Wolff, H.L.","year":"1969","unstructured":"Wolff HL. The faecal smear in the therapy of diarrhoeas. Trop Geogr Med 1969;21:427-35.","journal-title":"Trop Geogr Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"697","DOI":"10.7326\/0003-4819-76-5-697","article-title":"Fecal leukocytes in diarrheal illness","volume":"76","author":"Harris, J.C.; DuPont, H.L.; Hornick, R.B.","year":"1972","unstructured":"Harris JC, DuPont HL, Hornick RB. Fecal leukocytes in diarrheal illness. Ann Intern Med 1972;76:697-703.","journal-title":"Ann Intern Med"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1001\/archpedi.1974.02110310020004","article-title":"Acute diarrhea in a residential institution for the retarded","volume":"128","author":"Peirce, J.E.; DuPont, H.L.; Lewis, K.R.","year":"1974","unstructured":"Peirce JE, DuPont HL, Lewis KR. Acute diarrhea in a residential institution for the retarded. 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Am J Trop Med Hyg 1979;28:1031-5.","journal-title":"Am J Trop Med Hyg"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/infdis\/146.2.177","article-title":"Epidemiologic and clinical features of patients infected with Shigella who attended a diarrheal disease hospital in Bangladesh","volume":"146","author":"Stoll, B.J.; Glass, R.I.; Huq, M.I.; Khan, M.U.; Banu, H.; Holt, J.","year":"1982","unstructured":"Stoll BJ, Glass RI, Huq MI, Khan MU, Banu H, Holt J. Epidemiologic and clinical features of patients infected with Shigella who attended a diarrheal disease hospital in Bangladesh. J Infect Dis 1982;146:177-83.","journal-title":"J Infect Dis"},{"key":"ref_18","first-page":"1135","article-title":"Manson's tropical diseases","author":"Wilcocks, C.; Manson-Bahr, P.E.C.","year":"1978","unstructured":"Wilcocks C, Manson-Bahr PEC. Manson's tropical diseases. 17th ed. 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