An 8-Year-Old Boy with Acute Lymphoblastic Leukemia Receiving Maintenance Chemotherapy

An 8-year-old boy with acute lymphoblastic leukemia receiving maintenance chemotherapy is hospitalized due to fever and neutropenia.  Treatment with broad spectrum intravenous antibiotics is begun and the patient's fever resolves.  His neutrophil count increases with granulocyte colony-stimulating factor therapy and blood cultures remain negative.  On day 5 of hospitalization, the patient experiences nausea, abdominal cramping, and 6-8 episodes of watery diarrhea.  Temperature is 37.7 C (100 F) .  Physical examination shows mild lower abdominal tenderness without guarding or rebound tenderness.  Stool testing for occult blood is negative.  Which of the following is the single best stool test to establish the cause of this patient's diarrhea?

A) Culture on sorbitol-MacConkey agar
B) Enzyme immunoassay for bacterial antigen
C) Latex agglutination for viral antigens
D) Microscopy after modified acid-fast staining
E) Microscopy for ova and parasites
F) PCR for bacterial gene encoding a toxin

Correct Answer:

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