title: [Difficult-to-diagnose organisms responsible for diarrhea in the immunocompetent patient].
abstract: In cases of diarrhea, the two chief difficulties which the clinician must deal with are ability to demonstrate the nature of the pathogenic agent and, secondly, to be able to incriminate an organism found by stool culture as being pathogenic. The periodic emission of the parasite in coccidial infestations and in giardia infections requires repeated stool examinations. However, the persistence of a negative stool culture should lead to a search for a systemic cause such as malaria, a bacterial infection or toxin. Once an organism is identified, the distinction between a merely saprophytic nature and actual pathogenicity in the case of many parasites or candida can be determined on the basis of the clinical context and the underlying status of the patient. The epidemic context must also be taken into account, a healthy carrier state representing a fecal threat to other high risk patients, in particular regarding ameba and blastocyst infestations.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, CHR, Complexe du Bocage, Dijon.
authors.forename: J P
authors.initials: JP
authors.lastname: Kisterman
mesh_terms: D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D006801:Humans; D008487:Medical History Taking; D016273:Occupational Exposure; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D014195:Travel