Dysentry; Causes,symptoms,prevention and management

Dysentery

Dysentery is an infection of the intestines accompanied by bloody diarrhea. Is an important cause of colonic diarrhea in developing country and often spread through contaminated food or water. Dysentery is highly infectious and can be passed on if you don’t take the right precautions, such as properly and regularly washing your hands.

Cause

This is caused by amoeba and pathogenic species of Shigella and Viz:

  • Shigella dysenteri
  • Shigella flexneri
  • Shigella boydii
  • Shigella sonnei

Signs and Symptoms

  • Mucoid bloody diarrhea with severe central and lower abdominal pain.
  • Tenesmus
  • Malaise
  • Weight loss
  • Dehydration
  • Nausea and vomiting
  • Indigestion
  • a fever of 38C (100.4F) or above
  • Abdominal cramps
  • The diarrhea might be mild and meant to last for 2-3 days.

COMPLICATIONS

  • Septicaemia/Bactraemia
  • Severe Rectal Bleeding
  • Intestinal Perforation
  • Reiter’s syndrome

INVESTIGATIONS

  • Stool microscopy, culture and sensitivity (stool m,c,s)
  • Urea, electrolyte and creatinine
  • Full blood count

PREVENTION

Hand washing is the most important way to stop the spread of infection.

  • Wash your hands thoroughly with soap and water after going to the toilet.
  • Safe Drinking water
  • Adequate Sanitary Disposal
  • Environmental Hygiene
  • Hygienic food preparation
  • Where possible, stay away from other people until your symptoms have stopped.
  • Wash all dirty clothes, bedding and towels on the hottest possible cycle of the washing machine.
  • Clean toilet seats and toilet bowls, and flush handles, taps and sinks with detergent and hot water after use, followed by a household disinfectant.
  • Avoid sexual contact until you’ve been symptom free for at least 48 hours.

Risk groups are people in certain occupations – including healthcare workers and people who handle food – as well as people who need help with personal hygiene and very young children. Your environmental health officer will be able to advise you about this.

MANAGEMENT

The management of this condition is focused on adequate rehydration of the patient and eradicating the pathogen.

Rehydration

This can be achieved through

  • Fluid intake
  • Oral rehydration Therapy
  • IV fluids/ Parenteral administration

Drug Treatment

  • Analgesics and anti pyretic such as paracetamol, diclofenac to relieve pain and fever.
  • Antibiotics such as Ciprofloxacin 500-1000mg twice daily for 5-7 days (not for children below 18)
  • Amoxicillin 500mg thrice daily for 5 days
  • Cotrimoxazole 960mg twice daily for 3-5 days
  • Azithromycin 500mg once for 3 days for resistant stains.
  • Anti-Diarrhea drug aren’t always advised.

 

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