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Because certain strains of E. coli normally reside in the GI tract, culturing is of little value; a working diagnosis depends on clinical observation alone.
A firm diagnosis requires such sophisticated identification procedures as bioassays, which are expensive, time-consuming and, consequently, not widely available. The diagnosis must rule out salmonellosis and shigellosis, other common infections that produce similar signs and symptoms.
Source: Handbook of Diseases, 2003
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