Dysentery, Bacillary (Shigellosis)

General Illness Information


Medical Term:

Dysentery, Bacillary ( Shigellosis)

Common Name: None Specified

Description: Bacillary dysentery is a bacterial infection of the mucosal surface of the intestines, that results in severe diarrhea and is caused by Shigella bacteria. It has a 1-4 day incubation period. It is a contagious infection, occurs in epidemics and occurs more frequently in the summer and fall. The infection is spread by contact with feces of infected person. Epidemics are most frequent in overcrowded populations with inadequate sanitation.

Shigella bacteria cause dysentery throughout the world and are responsible for 5 to10 percent of all acute diarrheal illnesses.

Causes: This disease is caused by a bacteria -Shigella. It spreads from person to person by contact, or contaminated hands, food or drinking water.

Other bacteria that cause dysentery are Salmonella and Campylobacter

Prevention: Wash hands after bowel movements and before handling food. Isolate anyone with symptoms of bacillary dysentery. Immerse soiled clothes and bedclothes in covered buckets of soap and water until they can be boiled.

Signs & Symptoms

  • Diarrhea (up to 20 or 30 watery bowel movements in 1 day). Tends to be more severe in children, with sudden onset;
  • Blood, mucus or pus in the stool;
  • Abdominal cramps;
  • Fever. and chills;
  • Nausea or vomiting. Loss of appetite;
  • Muscle aches or pain;
  • Dehydration.

Risk Factors

  • Crowded or unsanitary living conditions;
  • Travel to foreign countries.

Diagnosis & Treatment

The history of sudden onset of diarrhea with presence of blood and mucus in the stools with associated symptoms of fever, chills, anorexia, malaise and headache in a person who lives in an area where Shigella is common is suggestive of Shigellosis.
Diagnostic test include laboratory studies and culture of stool specimen. Diagnosis is aided by knowledge of outbreaks in endemic areas.

In most case the disease resolves in 4 to 8 days. in severe cases may last 3 to 6 weeks.

General Measures:

  • Isolate the patient from others;
  • Treatment includes replacement of fluids and salts, low-residue diet and medications (if indicated);
  • Increase fluid intake;
  • Use of a heating pad or hot-water bottle on the abdomen may relieve pain;
  • Hospitalization of persons (especially small children with dehydration) who are seriously ill. Hospital care will include isolation and intravenous fluid supplements.

Medications:

Antibiotics may be prescribed. The current antibiotics of choice are Trimethoprim-sulfamethoxazole, ciprofloxacin and norfloxacin. Antibiotics are indicated when the patient is very young, when the disease is very severe or when the spread of infection to other people is likely. The severity of symptoms and the length of time the stool contains Shigella can be reduced with antibiotics.

Don’t use paregoric preparations or other anti-diarrhea drugs unless they are prescribed. Antispasmodics such as tincture of belladonna, are helpful when cramps are severe. Drugs that inhibit intestinal peristalsis e.g. paregoric, may ameliorate symptoms but prolong fever, diarrhea and excretion of Shigella in feces.

Activity:

Bed rest is necessary, except for trips to the bathroom, until fever, diarrhea and other symptoms have been gone for at least 3 days. The legs should be exercised regularly in bed.

Diet:

Liquid or soft diet until diarrhea stops, then return to normal diet.

Possible Complications:

  • Shigellosis may cause delirium, convulsions and coma but little or no diarrhea. This infection may be fatal in 12 to 24 hours;
  • Ulceration in the intestine can lead to severe blood loss;
  • Rectal prolapse;
  • Severe dehydration especially in children and in elderly, debilitated patients;
  • In rare cases, the bacteria may enter the bloodstream from the digestive tract and infect other body organs, such as kidneys, gallbladder, liver or heart and joints. This may cause shock and death.

Prognosis

Usually curable in 7 days with treatment. Most Shigella infections are mild and don’t require drastic treatment. In a severe attack, excessive dehydration can be fatal (especially in infants and young children) if treatment is unsuccessful.

Other

Nothing Specified.