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Synonyms
- Fecal Leukocyte Stain
- Stool for White Cells
- WBC, Stool
- White Cells, Stool
Test Includes
Evaluation of fecal material for the presence of WBC by direct smear and stain. CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed.
Expected Turnaround Time
3 - 7 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Stool
Volume
1 Gram
Container
Parasite (O & P) transport (PVA) vial only
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Quantity not sufficient for analysis; improper specimen transport device; improper labeling; unlabeled specimen or name discrepancy between specimen and request label; specimen received after prolonged delay
Test Details
Use
Assist in the differential diagnosis of diarrheal disease
Limitations
Ten percent to 15% of stools that yield an invasive bacterial pathogen have an absence of fecal leukocytes. Fecal leukocytes are present in idiopathic inflammatory bowel disease.
Methodology
Simple stain
Additional Information
Conditions associated with marked fecal leukocytes, blood and mucus include diffuse antibiotic associated colitis, ulcerative colitis, shigellosis, salmonellosis, Campylobacter, and Yersinia infection. Salmonella typhi may evoke a monocyte response. Conditions associated with modest numbers of fecal leukocytes include early shigellosis involving small bowel, antibiotic associated colitis, and amebiasis. Conditions associated with an absence of fecal leukocytes include toxigenic bacterial infection, giardiasis, and viral infections. In a review the methylene blue stain for polymorpholeukocytes had a high sensitivity 85% and specificity 88% for bacterial diarrhea (Shigella, Salmonella, Campylobacter). Positive predictive value was 59%. Negative predicative value was 97%. Combined with a history of abrupt onset, greater than four stools per day and no vomiting before the onset of diarrhea the stool methylene blue stain for fecal polymorphonuclear leukocytes was a very effective presumptive diagnostic test for bacterial diarrhea.1 A positive occult blood test may also be suggestive of acute bacterial diarrhea. Neither method is sufficiently sensitive or specific to preëmpt the use of culture.2 Similar findings including a sensitivity of 81% and specificity 74% were observed when both tests were positive.3
Footnotes
1. DeWitt TG, Humphrey KF, McCarthy P. Clinical predictors of acute bacterial diarrhea in young children. Pediatrics. 1985 Oct; 76(4):551-556. 4047797
2. Paccagnini S, Fontana M, Ceriani R, et al. Occult blood and faecal leukocyte tests in acute infectious diarrhea in children. Lancet. 1987 Feb 21; 1(8530):442. 2880230
3. Seigel D, Cohen PT, Neighbor M, et al. Predictive value of stool examination in acute diarrhea. Arch Pathol Lab Med. 1987 Aug; 111(8):715-718. 3632285
References
Bishop WP, Ulshen MH. Bacterial gastroenteritis. Pediatr Clin North Am. 1988 Feb; 35(1):69-87 (review). 3277134
Harris JC, Dupont HL, Hornick RB. Fecal leukocytes in diarrheal illness. Ann Intern Med. 1972 May; 76(5):697-703. 4554412
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 008656 | White Blood Cells (WBC), Stool | 13655-6 | 008656 | White Blood Cells (WBC), Stool | 13655-6 |
| Reflex Table for White Blood Cells (WBC), Stool | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 080025 | Result | 080026 | Result 1 | 13655-6 | |
| Reflex Table for White Blood Cells (WBC), Stool | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 080025 | Result | 080027 | Result 2 | 13655-6 | |
| Reflex Table for White Blood Cells (WBC), Stool | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 080025 | Result | 080028 | Result 3 | 13655-6 | |
| Reflex Table for White Blood Cells (WBC), Stool | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 080025 | Result | 080029 | Result 4 | 13655-6 | |
| Reflex Table for White Blood Cells (WBC), Stool | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 080025 | Result | 080030 | Antimicrobial Susceptibility | N/A | |
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The LOINC® codes are copyright © 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf