Acute Gastroenteritis Leukocytosis

Diagnostic Considerations

The American College of Physicians suggests that a total leukocyte count and differential can provide clues to bacterial etiology when viral or parasitic etiologies are also being considered 1
The Infectious Diseases Society of America recommends that total leukocyte count and neutrophil count are often elevated with invasive bacterial pathogens 1
In cases of bacterial sepsis, the total leukocyte count may be decreased compared to normal age values 1

Shigellosis may be associated with a leukemoid reaction (extreme leukocytosis) 1
STEC O157 (Shiga toxin-producing Escherichia coli) infections that later develop Hemolytic-Uremic Syndrome (HUS) often have elevated total leukocyte and neutrophil counts 1

The Centers for Disease Control and Prevention estimates that acute infectious gastroenteritis is a frequent cause of outpatient visits and hospitalizations in the United States, with an estimated annual burden of 179 million outpatient visits and nearly 500,000 hospitalizations 2

The World Gastroenterology Organisation recommends that laboratory tests may not accurately reflect the severity of the clinical condition, especially in immunocompromised patients 3
The European Society of Clinical Microbiology and Infectious Diseases suggests that a specific test for Clostridioides difficile and its toxin should be performed in cases of diarrhea with or without acute abdomen 3
The American College of Gastroenterology recommends that frequent monitoring of hemoglobin and platelet count, electrolytes, blood urea, and creatinine is necessary when HUS is suspected 1
Patients with decreasing platelet count during days 1-14 of diarrheal disease have a higher risk of developing HUS 1

The Society of Surgical Oncology states that enterocolitis (typhlitis or ileocecal syndrome) is the most common cause of acute abdominal pain in neutropenic cancer patients 3
The European Society for Medical Oncology recommends that enterocolitis typically presents with neutropenia associated with one or more of the following signs and symptoms: fever, intestinal wall thickening, diarrhea, and abdominal pain 3
Patients with inflammatory bowel disease (IBD) have an increased risk of developing C. difficile infection, along with worse outcomes, higher colectomy rates, and higher recurrence rates 5