Bacilli dysentery

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Overview

In certain patients with bacillary dysentery (particularly in infants and older adults), significant dehydration may result from excessive fluid loss through diarrhea and vomiting. The fluid losses can generally be replaced by oral intake because the diarrhea associated with bacillary dysentery is not normally associated with profound fluid and electrolyte depletion. If vomiting or extreme toxemia is a prominent feature of the illness, especially in the very young or very old, intravenous fluid replacement may be necessary. As in all diarrheal illnesses, fluid repletion is the mainstay of therapy and should be given even as antimicrobial therapies are being considered.


Antibiotics are useful in the management of shigellosis and may be lifesaving in the case of Shiga dysentery. Because the infection is normally self-limited and because antibiotic resistance commonly develops in populations after prolonged use of drugs, some experts and the Centers for Disease Control and Prevention (CDC) recommend that antimicrobial therapy be reserved for the most severely ill patients—those with immunosuppression, with bacteremia, or with complications and those who are hospitalized; for food handlers, residents of nursing homes, or childcare providers; or for situations in which spreading and outbreaks are possible. However, because the infection is generally transmitted from person to person and the infected or colonized person represents the major reservoir of infection, for public health reasons individuals with a positive stool culture or with known bacillary dysentery who are living or working in facilities with high risk for transmission (daycare centers, nursing homes) should be treated.


Because of the emergence of drug resistance, the efficacy of fluoroquinolones, trimethoprim-sulfamethoxazole, and macrolides in adults as empirical therapy when susceptibility is unknown has diminished. Risk factors for antimicrobial resistance include foreign travel, particularly to Southeast Asia and Africa; men who have sex with men; and HIV coinfection. For persons without these risk factors, a fluoroquinolone remains the drug of choice; for persons with these risk factors, cefixime or ceftriaxone is a reasonable alternative. For cases in which susceptibility is known,Trimethoprim-sulfamethoxazole had been the treatment of choice for this enteric infection, but resistance has become widespread for strains ofShigella. Although 3-day therapy is generally recommended in shigellosis, single-dose fluoroquinolones may be given for milder forms of shigellosis.For children, various drugs may be used. Cephalosporins have become a common form of treatment of pediatric shigellosis. Although not approved for use in children, short-course fluoroquinolones can be safely used Amdinocillin, an unlicensed drug, has been used in Bangladesh for shigellosis. Azithromycin has been used successfully for treatment of multidrug-resistantShigella infection in adults and should be useful in the management of pediatric shigellosis. Nalidixic acid may be helpful in the management of pediatric shigellosis.Rifaximin should not be used to treat shigellosis. However, it has been proven to prevent shigellosis in experimental challenge studies and is an option to prevent traveler's diarrhea, probably by eradicatingShigella infection before the organisms reach the colon and establish infection.


Symptoms

Bacillary dysentery is a gastrointestinal disease caused by bacterial infection. Symptoms include severe diarrhea, fever, stomach pain, nausea and vomiting. The condition is most common in developing countries with poor sanitation. Some cases can be life-threatening and require antibiotics and hospitalization.

 Dysentery is infection and inflammation of the intestines, which causes diarrhea that may contain blood or mucus. Other possible symptoms include abdominal pain, nausea and vomiting, and fever. Dysentery can occur as a result of bacterial or parasitic infections.

Causes

The bacterial infections that can lead to bacillary dysentery are very contagious. The bacteria are usually passed from person to person when fecal matter (poop) from an infected person gets into another person's mouth.

Bacillary dysentery is a gastrointestinal disease caused by bacterial infection. Symptoms include severe diarrhea, fever, stomach pain, nausea and vomiting. The condition is most common in developing countries with poor sanitation. Some cases can be life-threatening and require antibiotics and hospitalization.

Risk factors

The top four factors are age group, per capita GDP, population density and rural population proportion, and their determinant powers are 61%, 27%, 25% and 21%, respectively. The interactive effect between age group and the other factors accounts for more than 60% of bacillary dysentery transmission.

Attendance or work in a day care setting.

Close contact with an infected person or animal.

Consumption of untreated water from lakes, rivers or streams.

Fecal to oral contact.

Travel in countries where the infection is common.

Use of public swimming pools.

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Complications

Dysentery can cause medical complications. These are more common among people with compromised immune systems.


Some potential complications of dysentery include:


Dehydration: Frequent diarrhea and vomiting can lead to dehydration. In infants and young children, this can quickly become life-threatening.

Liver abscess: Amebic dysentery can causeTrusted Source an abscess in the liver.

Postinfectious arthritis (PIA): A person may develop PIA as a complication of Shigella infection. Symptoms include joint pain, inflammation, and stiffness.

Hemolytic uremic syndrome: A condition involving inflammation and damage to the small blood vessels within the kidneys. It is a rare complication of Shigella infection.

Prevention

Dysentery outbreaks usually occur as a result of poor hygiene or sanitation. To reduce the risk of infection, people should wash their hands regularly with soap and water, especially after using the bathroom and before preparing food.


The risk of contracting dysentery is higher for people traveling to countries with warm, moist climates and poor sanitation. When traveling to such places, a person should:


only drink reliably sourced water, such as bottled water

ensure that bottled water has an unbroken seal before drinking

avoid ice cubes, as the water may be from a contaminated source

use only bottled or purified water to clean the teeth

cook food thoroughly before eating