Diagnosing Acute Bacterial Diarrhea

Although bacteriologic culture is the gold standard for differentiating acute bacterial from acute noninfectious diarrhea, this method takes a minimum of 48 hours and costs around $1,000 per positive culture. The fecal occult blood test (FOBT) and fecal lactoferrin also have been used to differentiate the problems, but studies of their accuracy have had widely varying results. Could fecal calprotectin—a calcium binding cytosolic neutrophil protein that is the most accurate identifier of chronic diarrhea’s inflammatory causes—offer a cheap, fast, and accurate alternative?