E. coli: Escherichia coli 0157:H7, E. coli 0157:H7 (cont.)
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E. coli 0157:H7 Diagnosis
The diagnosis is usually made by an accurate history, physical exam, and analysis of the fecal sample. A presumptive diagnosis is made if the patient's history indicates an association with persons, foods, or fluids known to contain E. coli 0157:H7; such a presumptive diagnosis is often made during outbreaks of the disease.
Culture of E. coli 0157:H7 from a fecal specimen on selective media (sorbitol-MacConkey agar) gives a definitive diagnosis of the infection when clear-appearing colonies react with 0157 antiserum. Other tests include PCR and immunofluorescence tests. The CDC has recommended that all patients being evaluated for community-acquired diarrhea should have their stool samples analyzed by immunologic test systems that detect all types of Shiga toxins as this test will likely detect almost all bacteria that produce Shiga toxins, especially the E. coli 0157:H7 strains. The CDC suggests that this test is even better than bacterial culture techniques, but recommend that both culture and immunologic tests should be done at the same time.
Bhupinder Anand, MD
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