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Diagnosis of escherichiosis
Medical expert of the article
Last reviewed: 03.07.2025
The symptoms of escherichiosis are similar to the clinical picture of other diarrheal infections. Therefore, the diagnosis of escherichiosis is based on the use of bacteriological research methods. Material (feces, vomit, gastric lavage, blood, urine, cerebrospinal fluid, bile) should be taken in the first days of the disease before the patient is prescribed etiotropic therapy. Sowing is done on Endo, Levin, Ploskprev media, as well as on Müller enrichment medium.
Immunological diagnostics of escherichiosis is also used, namely RA, RIGA in paired sera, but they are not convincing, since false positive results are possible due to antigenic similarity with other enterobacteria. These methods are used for retrospective diagnostics, especially during an outbreak.
A promising diagnostic method is PCR. Instrumental diagnostics of escherichiosis (rectoscopy, colonoscopy) is uninformative.
The diagnosis of Escherichia coli is valid only with bacteriological confirmation.
[ Differential diagnosis of escherichiosis
Differential diagnostics of Escherichia coli is carried out with other acute diarrheal infections: cholera, shigellosis, salmonellosis, campylobacteriosis, food poisoning of staphylococcal etiology and viral diarrhea: rotavirus, enterovirus, Norwalk virus infection, etc.
Unlike escherichiosis, cholera is characterized by the absence of intoxication, fever, pain syndrome, the presence of repeated vomiting, and the rapid development of dehydration of grades III-IV. Epidemiological history helps in making a diagnosis - staying in regions endemic for cholera.
Shigellosis, unlike escherichiosis, is characterized by high fever, pain is localized in the left iliac region. The spasmodic, painful sigmoid is palpated. The stool is scanty, in the form of "rectal spit".
Salmonellosis, unlike escherichiosis, is characterized by more pronounced intoxication, diffuse abdominal pain, pain on palpation in the epigastric and umbilical regions, rumbling. A foul-smelling, greenish stool is characteristic.
For food toxicoinfection of staphylococcal etiology, in contrast to escherichiosis, an acute, violent onset of the disease is characteristic, a short incubation period (30-60 minutes), more pronounced symptoms of intoxication, uncontrollable vomiting. Abdominal pain of a cutting nature, localized in the epigastric and periumbilical regions. The group nature of the disease, the connection of the disease with a food factor, and rapid regression of the disease are characteristic.
Rotavirus gastroenteritis, unlike escherichiosis, is characterized by catarrhal symptoms, changes in the mucous membrane of the oropharynx (hyperemia, granularity), weakness, and adynamia. Abdominal pain is diffuse, the stool is liquid, "foamy", with a sharp, sour odor, the urge to defecate is imperative. On palpation, a "large-caliber" rumbling is noted in the area of the cecum, less often the sigmoid colon.
Example of diagnosis formulation
A04.0. Escherichia coli 018, gastroenteric form of moderate severity.