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Fecal Leukocytes

WBC, leukocyte, Gram Stain, methylene blue, inflammatory diarrhea, non-inflammatory diarrhea

Test Codes

Antrim #40274, EPIC: LAB5514, SOFT: FWBC

Department

Microbiology

Instructions

• The preferred test for all patients, including non-breast fed infants, is the Fecal Lactoferrin test. All unpreserved stool specimens received in the Laboratory from patients greater than or equal to 18 months of age will automatically be analyzed with the Fecal Lactoferrin test.
• This test may be falsely negative if tested on immunocompromised patients with decreased levels of neutrophils.
• At least two weeks should elapse following barium administration before collection of the specimen.

Specimen Collection Criteria

Collect (preferred specimen): Random stool specimen in SAF preservative.
Also acceptable: Random stool specimen or duodenal aspirate in a sterile collection container.

Deliver unpreserved stool specimen to the Laboratory within 1 hour of collection. If received after 1 hour of collection, the Laboratory will automatically perform the Fecal Lactoferrin test, if the patient is 18 month of age or older. Fecal leukocytes deteriorate rapidly in the unpreserved state.

For nursing infants, specimens must only be collected at the Grosse Pointe, Royal Oak, or Troy Hospital campuses and submitted to the Laboratory within one hour of collection. 

Physician Office/Draw Specimen Preparation

Maintain specimen at room temperature (20-26°C or 68-78.8°F) prior to transport. Unpreserved specimens must be delivered to the Laboratory within one hour of collection.

Preparation for Courier Transport

Transport: Stool specimen in SAF preservative at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

• More than one specimen per patient collected within a 24 hour period.
• Stool collected following a soap suds enema.
• Stool specimens received in non-approved containers (e.g., diapers, pill bottles, containers with wax lining, containers intended or used for food, other household containers, etc).
• Unpreserved stool specimen NOT received within 1 hour of collection on patients less than 18 months of age. In this instance the Fecal Lactoferrin test cannot be performed.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 1 hour (Unpreserved)
Room Temperature (20-25°C or 68-77°F): 7 days (Preserved)
Refrigerated (2-8°C or 36-46°F): 7 days (Preserved)
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Grosse Pointe sent to Royal Oak Microbiology Laboratory for testing.
Royal Oak Microbiology Laboratory
Troy sent to Royal Oak Microbiology Laboratory for testing.

Performed

Monday – Friday, 7:00 am – 3:30 pm.
Results available within 24 hours.

Reference Range

No fecal leukocytes seen.

Test Methodology

Stain, microscopic examination.

Clinical Utility

The detection of fecal leukocytes (WBC's) has been used to differentiate inflammatory diarrheas (which can be life-threatening) from the non-inflammatory diarrheas.

This procedure is not recommended for diagnostic purposes because it often provides results of little clinical value and the results could be misleading (1).

Reference

1. Vandamme, P.A.R., 2015. Specimen collection, transport, and Processing: Bacteriology. In: Jorgensen, J.H., et. al. (eds.). Manual of Clinical Microbiology. 11^th ed. ASM Press. Washington, D.C.

CPT Codes

89055

Contacts

Last Updated

8/20/2020