ENTEROCOLITIS

Patient 2: Kwan Siew Lan
Age: 28
Complaints: Diarrhea
Diagnosis: Enterocolitis
Antibiotic treatment (if any): Nil
Specimen: Stool


Enterocolitis

Enterocolitis is the inflammation of the large and small intestines. Enteritis specifically refers to an inflammation of the small intestine and colitis specifically refers to inflammation of the large intestine.


Investigations

Cultures
Cultures are to be done on Macconkey, Salmonella Shigella and Campylobacter agar plates. An additional test will be the Selenite Broth (enrichment medium for Salmonella and Shigella).

MacConkey agar is a medium recommended for use in the isolation and differentiation of lactose-fermenting organisms from non-fermenting Gram-negative enteric bacteria.

Salmonella Shigella and Campylobacter agars are selective mediums that only permit the growth of Salmonella, Shigella and microaerophillic Campylobacter species respectively.

Microscopy
1) Gram Stain - To be done when culture is ready. It is to determine the type of bacteria (Gram-positive or gram-negative) that has grown and decide on the number of biochemical tests to do and also the type of antibiotic sensitivity tests to do.
2) Ova and Cysts – To look for ova and cysts in the specimen that could be a possible cause of diarrhea.

Biochemical Tests
From the microscopy results, decide on the type of tests to do. If the gram stain shows gram negative bacilli, do an oxidase test. For oxidase-negative gram-negative bacilli, proceed to 5 tubes test (KG, SC, Urea, MOT, IND) if it is a lactose fermenter and 7 tubes test (KG, SC, Urea, MOT, IND, PPA, MAL) if it is a non-lactose fermenter.


Possible microorgainisms

Salmonella typhi – Gram-negative bacilli
Vibrio parahaemolyticus
Campylobacter species
Giardia lamblia


Posted by Melva Lim