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In this issue of Clinical Infectious Diseases, Echenique and colleagues report the frequency of infectious causes and diagnostic yield of microbiologic tests in a large retrospective cohort of hospitalized SOT patients with community- and hospital-onset diarrhea [ 8].
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The primary outcome of the study was bacteremia confirmed by microbiologic testing in patients initially presenting to the ED with fever.
Our results demonstrate that microbiologic testing in pediatric cancer patients with pneumonia, with the exception of mechanically ventilated patients with acute respiratory failure, often fails to identify the causative agent [ 6].
The second phase will consist of completing our testing set for external validity and comparing CLSA with the current WHO algorithm and other diagnostic tools such as physical exam findings, chest ultrasound and microbiologic testing in order to construct an improved algorithm for pneumonia diagnosis.
Ordering microbiologic tests late in the patient's illness may be of limited use if patients have also received empirical antibiotic treatment and/or have shown development of complicating nosocomial infections.
The patients' age and sex and the results of microbiologic tests are presented in the Table.
Appropriate antibiotic treatment: at least one antibiotic shown to be effective in microbiologic tests administrated within 24 hours.
Thus, microbiologic tests must be interpreted critically in the context of the clinical presentation.
As additional diarrheal pathogens have come to be described in recent years and as diagnostic microbiologic tests have become more sensitive, the need for a definitive study of pediatric diarrheal disease gained widespread support and momentum [ 10].
In March 2003, although chemotherapy was well tolerated, microbiologic tests of two bronchoalveolar lavage (BAL) specimens continued to be AFB smear- and culture-positive.
Microbiologic tests were negative.
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