Green stool with mucous in my stool examination is a frequently asked question, I must explain this for you by live case study, liquefied green stool is a sharp indicative of diarrhea, in this article we will show a medical report for a patient admitted in a hospital for 3 days to be cured of severe diarrhea of unknown reason, How doctor will use medical examinations and lab tests to diagnose the type of diarrhea
Medical report of an infectious diarrhea case study:
Complain: 57 years old male complaining of dizziness & diarrhea
On Examination: -Pulse: 82 beat /minute Blood pressure: 160/110 mmHg Temperature: 37.5 C RR: 16 cycle /min
-Cardiac examination: Clinically free
-Chest examination: clinically free
-Neurological examination: the patient is conscious, alert, well oriented to time, place &person, no motor, no sensory deficits.
-Abdomino-pelvic examination: No masses' or organomegally.
Investigation tests:
-CBC -Cardiac enzymes -Kidney function & liver function test -lipid function -RBS -stool analysis and urine analysis
Blood test results:
Blood work results show Normal Cardiac enzymes, normal Kidney function & liver function tests, and lipid panel within normal as well as controlled RBS; and other results are reported below.
Complete blood Picture
WBC: 15.0 mil/Cumm (Normal WBC count: 3.5 -11.0)
Differential leucocytes count:
Baso: 0
Eosino: 2
Staff- neutrophils: 4
Seg- neutrophils: 75
Monocytes: 5
Lymphocytes: 14
RBC: 4.2 mil/Cumm (Normal RBC count: 3.80-5.80)
Hb: 11.5 g/dl (Normal Hb level: 11.0 -16.5)
HCT: 40 %
Platelet (PLT): 256 mil/Cumm
Comments: CBC show mild leucocytosis with neutrophilia
Complete urine Analysis:
Pus cells: 8 – 10 /HPF
RBC cells: 5- 7 /HPF
Amorphus urates: (+)
Complete Stool Examination:
MACROSCOPIC PICTURE
Color: Green
Mucous : (++)
Consistency: Liquid
Odor: Offensive
Worms: NIL
MICROSCOPIC PICTURE
Pus Cells: 30-40
R.B. Cells: 4 - 6
Ova: NIL
Larvae: NIL
Undigested food: (+)
Parasites: Entamoeba histolytica Cysts
Blood results interpretation:
All cardiac, liver, renal function tests show normal results; therefore diarrhea associated with liver function disturbances will be neglected.
Complete blood count show High leucocytosis with increased count of segmented neutrophilic cytes which is associated with bacterial infection invasions.
Urinalysis shows no problems may be a reason to cause diarrhea.
Stool analysis show increase in the microscopic count of Pus cells, pus cells is a white blood cells died after invasion of a microorganism as bacteria or Parasites, liquefied green stool and mucous support the diagnosis of infectious diarrhea.
What is diarrhea: Diarrhea is when you pass loose or watery stool, diarrhea is the opposite of constipation.
The expected diagnosis of this case after reading his/her blood work results: it is expected to be infected with intestinal Parasite called entamoeba histolitica cyst which ingest and nourishment on body digested foods in intestines, body’s immunity system response onsuchparasitic invasion by releasing high quantity of specialized blood cells called Neutrophils which invade Entamoeba cysts and kill them by swallow them then converted to died white blood cell which medically called “Pus cell” and exhausted in urine or stool masses.
Lab Recommended for follow up by GIT physician.
Provisional diagnosis: Acute diarrhea with essential hypertension & dizziness. under observation for more investigations.
Treatment:
- Frusimide 20mg 2 AMP IVI
-Ringer infusion 500 CC IVI
-Glucose 5%500 cc IVI
-Zantac (Randitine) ampoule IVI once
-Flagyl(metronidazole) infusion
-The patient improved and was dischareged with:-
-Antinal tab one tab every 8 hour
- Gastrig tab 200mg one tab every 12 hour
-betacerik tab one tab every day.
