Fecal Leukocytes, Stool
Norm of Fecal Leukocytes, Stool
No leukocytes present.
Usage of Fecal Leukocytes, Stool
Determine the type of diarrhea, invasive or noninvasive, to the mucosa of the colon. If no fecal leukocytes are present in the stool specimen, an antidiarrheal medication can be given. If fecal leukocytes are present, an antidiarrheal medication should not be given. The results of this test will be readily available, whereas a culture will take several days.
Description of Fecal Leukocytes, Stool
The presence of fecal leukocytes in the stool indicates that the cause of the diarrhea is an organism such as Shiga toxin–producing E. coli or a process that is breaking the mucosal barrier of the colon, such as Salmonella, Shigella, Amoeba, Campylobacter, Helicobacter, or Yersinia infections, Crohn's disease, and chronic inflammatory bowel disease. Fecal leukocytes are usually not present in infectious processes that do not invade the mucosa, such as “viral enteritis,” toxin-mediated diarrhea, or infections with noninvasive E. coli. The absence of blood and fecal leukocytes usually means that the diarrhea process is transient and can be treated symptomatically. Clostridium difficile may or may not be associated with leukocytes in the stool (fecal leukocyte stain is 14% sensitive and 90% specific); therefore if it is suspected, a stool culture should be sent and no antidiarrheal agent given until the results are confirmed as negative.
Professional Considerations of Fecal Leukocytes, Stool
Consent form is NOT required.
Preparation
- Obtain a stool specimen container.
Procedure
- Instruct the client to collect a stool sample, or use a bedpan so that the sample can be obtained.
- Send the specimen to the laboratory.
Postprocedure Care
- Keep the rectal area as clean and as dry as possible to prevent skin breakdown.
- If diarrhea is frequent, encourage fluids and check serum electrolytes for abnormalities.
Client and Family Teaching
- Avoid contaminating the stool with toilet tissue or urine.
- Results are normally available within 48 hours.
Factors That Affect Results
- None.
Other Data
- Stool cultures should be obtained from all clients with fecal leukocytes to differentiate acute infection from inflammatory bowel syndrome. In the absence of fecal leukocytes, stool cultures are usually negative.
