Dysentery
Dysentery, infectious disease characterized
by inflammation of the intestine, abdominal pain, and diarrhea with stools that
often contain blood and mucus. Dysentery is a significant cause of illness and
death in young children, particularly those who live in less-developed
countries. Each year worldwide, there are between 120 million and 165 million
cases of Shigella infection, of which 1 million are
fatal. Over 60 percent of these fatalities are children under 5 years old in
developing countries.
Symptoms
The
main symptom of dysentery is frequent near-liquid diarrhea flecked with blood,
mucus, or pus. Other symptoms include:
·
sudden
onset of high fever and chills
·
abdominal
pain
·
cramps
and bloating
·
flatulence
(passing gas)
·
urgency
to pass stool
·
feeling
of incomplete emptying
·
loss
of appetite
·
weight
loss
·
headache
·
fatigue
·
vomiting
·
dehydration
Other
symptoms may be intermittent and may include recurring low fevers, abdominal
cramps, increased gas, and milder and firmer diarrhea. You may feel weak and
anemic, or lose weight over a prolonged period (emaciation). Mild cases of
bacillary dysentery may last 4 to 8 days, while severe cases may last 3 to 6
weeks. Amoebiasis usually lasts about 2 weeks.
Cause
The
World Health Organization (WHO) identifies two main types of dysentery.
Bacillary dysentery, or shigellosis
This
type produces the most severe symptoms. It is caused by the Shigella
bacillus. Poor hygiene is the main source. Shigellosis can also spread because
of tainted food. In Western Europe and the U.S., it is the most common type of
dysentery in people who have not visited the tropics shortly before infection.
Amoebic dysentery, or amoebiasis
This
type is caused by Entamoeba histolytica
(E. histolytica), an amoeba. The amoebae group
together to form a cyst, and these cysts emerge from
the body in human feces. In areas of poor sanitation, the amoebae can
contaminate food and water and infect other humans, as they can survive for
long periods outside the body. They can also linger on people's hands after
using the bathroom. Good hygiene practice reduces the risk of spreading
infection. It is more common in the tropics, but it sometimes occurs in parts
of rural Canada.
Other causes- Other causes include a parasitic
worm infection, chemical irritation, or viral infection.
Complications
·
Complications
of dysentery are few, but they can be severe.
·
Dehydration:
Frequent diarrhea and vomiting can quickly lead to dehydration. In infants and
young children, this can quickly become life-threatening.
·
Liver
abscess: If amoebae spread to the liver, an abscess can form there.
·
Postinfectious arthritis: Joint pain may occur following the
infection.
·
Hemolytic
uremic syndrome: Shigella dysenteriae
can cause the red blood cells to block the entrance to the kidneys, leading to
anemia, low platelet count, and kidney failure.
·
Patients
have also experienced seizures after infection.
Diagnosis
The
doctor will ask the patient about their signs and symptoms and carry out a
physical examination. A stool sample may be requested, especially if the
patient has recently returned from the tropics. If symptoms are severe,
diagnostic imaging may be recommended. This could be an ultrasound scan or an
endoscopy.
Treatment
Dysentery
is managed by maintaining fluids by using oral rehydration therapy. If this
treatment cannot be adequately maintained due to vomiting or the profuseness of
diarrhea, hospital admission may be required for intravenous fluid replacement.
In ideal situations, no antimicrobial therapy should be administered until
microbiological microscopy and culture studies have established the specific
infection involved. When laboratory services are not available, it may be
necessary to administer a combination of drugs, including an amoebicidal drug to kill the parasite, and an antibiotic to
treat any associated bacterial infection. If shigellosis is suspected and it is
not too severe, letting it run its course may be reasonable — usually less than
a week. If the case is severe, antibiotics such as ciprofloxacin or TMP-SMX may
be useful. However, many strains of Shigella are
becoming resistant to common antibiotics, and effective medications are often
in short supply in developing countries. If necessary, a doctor may have to
reserve antibiotics for those at highest risk for death, including young
children, people over 50, and anyone suffering from dehydration or
malnutrition. Amoebic dysentery is often treated with two antimicrobial drug such as metronidazole and paromomycin or iodoquinol.
Prevention
·
Dysentery
mostly stems from poor hygiene.
·
To
reduce the risk of infection, people should wash their hands regularly with
soap and water, especially before and after using the bathroom and preparing
food.
·
This
can reduce the frequency of Shigella infections and
other types of diarrhea by up to 35 percent.
·
Other
steps to take when the risk is higher, for example, when traveling, include:
·
Only
drink reliably sourced water, such as bottled water
·
Watch
the bottle being opened, and clean the top of the rim before drinking
·
Make
sure food is thoroughly cooked
·
It
is best to use purified water to clean the teeth, and avoid ice cubes, as the
source of the water may be unknown.
·
Always
use a condom for any sexual activity involving anal contact and wash carefully
before and after sexual activity.
·
Do
not eat any foods cooked in unhygienic circumstances, such as from street
vendors.