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A recent paper asked the question the other way around. Do patient with C. difficile reliably have fecal leukocytes? The findings were that only 9/30 C. difficile positive patients had fecal leukocytes. Put another way 70% of C difficile positive patients were fecal leukocyte negative. Therefore using a negative fecal leukocyte screen to rule out C. difficile is a bad idea. (Reddymasu et. al. www.ann.clinmicro. com 2006, 5:9) As far as fecal lactoferrin the data are perhaps better but it is still not a good idea to use as a test to rule C. difficile disease again patients with C. difficile can be negative by the fecal lactoferrin test.
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