2．消化管感染症の診断手順―症候，血清，糞便検査，PCRを含む

Diagnostic Procedures for Infectious Colitis (Including Symptoms, Serological, Stool Test and PCR)

要旨　感染性腸炎の鑑別診断を行う場合，最も重要なのは臨床所見である．詳細な病歴から感染性腸炎との診断が可能なばかりでなく，疾患の絞り込みも可能である．これに便や血液を用いた細菌学・生化学的検査所見を加えることでほとんど感染性腸炎の確定診断が可能となる．内視鏡生検組織を用いた組織検査，培養検査，さらに生検組織所見や病原菌に対する特殊染色・免疫組織化学・DNAプローブによる検索なども確定診断に有用である．X線・内視鏡などの画像所見は，病変の部位，形状，配列などを分析することで潰瘍性大腸炎やCrohn病などの狭義のIBDとの鑑別に有用である．

　In order to make a differential diagnosis and obtain a precise diagnosis of infectious colitis, the evaluation of clinical findings is of most importance. Taking a detailed disease history leads to a diagnosis of infectious colitis as well as helping to narrow down the possitilites to a precise diagnosis. Definite diagnosis can be obtained by adding some tests such as bacterial examination with use of stool or blood and biochemical tests. It is also useful to append histological microscopic findings, histologic culture, immunohistochemical examination specific for the causative bacteria and a DNA probe using biopsy specimens obtained by colonoscopy. Imaging study of radiologic or colonoscopic examination and analysis of the location, shape and allignment of the lesions are invaluable for the differential diagnosis of infectious colitis from inflammatory bowel diseases such as ulcerative colitis or Crohn's disease.