Dysente RY: ALVAREZ, Ronilyn A. BSN Ii-B

DYSENTE
RY
ALVAREZ, Ronilyn A.
BSN II-B
WHAT IS DYSENTERY?
Dysentery is a inflammatory disorder of the intestine, especially the
colon, which results in severe diarrhea containing mucus and / or
blood in the stool. If left untreated, dysentery can be fatal. (WHO
definition)
THERE ARE TWO MAIN

TYPES OF DYSENTERY.
Amoebic dysentery (amoebiasis)
- This is caused byEntamoeba histolytica, a type of amoeba, and is
more common in the tropics. An amoeba is a protozoan (singlecelled) organism that constantly changes shape.
Bacillary dysentery (shigellosis)
- It is caused byShigella, a bacterium. In Western Europe and the
USA it is the most common type of dysentery among people who
have not recently been to the tropics.
DID YOU KNOW?

The World Health Organization estimates that shigellosis accounts
for about 120 million cases of severe dysentery with blood and
mucus in stools worldwide. The vast majority of cases occur in
developing nations among children aged less than five years.
Approximately 1.1 million people are thought to die from Shigella
infection globally each year. Sixty percent of these deaths are
among very young children.
CAUSATIVE AGENTS
Bacillary dysentery
Four species of the genusShigella:
S. dysenteriae, the most virulent species and the one most likely to
cause epidemics
S. sonnei, the mildest species and the most common form
ofShigella found in the United States;S. boydii; andS. flexneri.
Amebic dysentery
Caused by a protozoon,Entamoeba histolytica, whose scientific
name means "tissue-dissolving. The cysts may be found in food or
water contaminated by human feces. Once in the digestive tract,
the cysts break down, releasing an active form of the organism
called a trophozoite. The trophozoites invade the tissues lining the
intestine, where they are usually excreted in the patient's feces.
They sometimes penetrate the lining itself, however, and enter the
bloodstream. If that happens, the trophozoites may be carried to
the liver, lung, or other organs. Involvement of the liver or other
organs is sometimes called metastatic amebiasis.
Balantidiasis, giardiasis,andcryptosporidiosis.
These three intestinal infections are all caused by
protozoa,Balantidium coli, Giardia lamblia, andCryptosporidium
parvumrespectively. Although most people infected with these
protozoa do not become severely ill, the disease agents may cause
dysentery in children or immunocompromised individuals.
Viral dysentery
which is sometimes called traveler's diarrhea or viral
gastroenteritis,is caused by several families of viruses, including
rotaviruses, caliciviruses, astroviruses,noroviruses,and
adenoviruses. There are about 3.5 million cases of viral dysentery
in infants in the United States each year, and about 23 million
cases each year in adults.
Dysentery caused by parasitic worms

Both whipworm (trichuriasis) and flatworm or fluke
(schistosomiasis) infestations may produce the violent diarrhea and
abdominal cramps associated with dysentery.
Having sex that involves anal contact may spread amoebic

and bacillary dysentery.
This is especially true if the sex included direct anal or oral contact,
or oral contact with an object (e.g., fingers) that touched or was in
the anus of an infected person.
SIGNS AND 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
Children and infants show signs of dehydration as being thirsty, restless, irritable, and possibly lethargic. They may also have
sunken eyes, reduced quantity tears or urine, urine becoming very dark and concentrated.
BE CAREFUL!
Complications from bacillary dysentery include delirium,
convulsions, and coma.A very severe infection like this can be
fatal within 24 hours. However, the vast majority of infections are
self-limited and resolve spontaneously without treatment.
People with amoebic dysentery may experience other problems
associated with amoebiasis. The most frequent complication results
when parasites spread to the liver, causing an amoebic abscess. In
this case, you would have a high fever and experience weight loss
and right shoulder or upper abdominal pain. If the infection of the
bowel is especially virulent, the intestinal ulcerations may lead to
bowel perforation and death. The parasites may rarely spread
through the bloodstream, causing infection in the lungs, brain, and
other organs.
PREVENTION
You can reduce your risk of getting dysentery with good hygiene. You should:
- Always wash hands thoroughly before eating, and after using the toilet
- Drink boiled water and beverages made with boiled water only.
- Avoid using unsealed water or beverages, as it can be contaminated.
- Ice added to drinks can be made from contaminated water, always prepare it from
boiled water.
- Always wash fruits or vegetables with boiled water only.
- Food should be cooked at a high temperature for a considerable time, as it kills any
microorganisms present.
- Fish, esp. shellfish which can contain microorganisms should not be cooked well with
proper heating.
- Foodstuffs from sealed containers e.g. jar and cans, should be always purchased
unopened.
IF YOU'RE TRAVELLING TO A COUNTRY WHERE THERE

IS A HIGH RISK OF GETTING DYSENTERY, THE ADVICE
BELOW CAN HELP TO PREVENT INFECTION.
- Don't drink the local water unless you're sure that it's sterile (clean)
safe alternatives are bottled water or drinks in sealed cans or bottles.
- If the water is not sterile, boil it for several minutes or use chemical
disinfectant or a reliable filter.
- Don't clean your teeth with tap water.
- Don't have ice in your drinks, because it may be made from unclean
water.
- Avoid fresh fruit or vegetables that can't be peeled before eating.
- Avoid food and drink sold by street vendors (except drinks from
properly sealed cans or bottles).
MANAGEMENT
Diagnostic tests:
Stool and blood tests
Cultures of stool samples are examined in order to identify the
organism causing dysentery. Usually, several samples must be
obtained due to the changing number of amoeba, which changes
daily.
Blood tests can be used to measure abnormalities in the levels of
essential minerals and salts.
MANAGEMENT
Consider the following to determine the source/cause of the
patients diarrhea:
- Stool characteristics (eg, consistency, color, volume, frequency)
- Presence of associated enteric symptoms (eg, nausea/vomiting, fever, abdominal
pain)
- Use of child daycare (common pathogens: rotavirus, astrovirus, calicivirus;
Campylobacter,Shigella,Giardia, andCryptosporidiumspecies [spp])
- Food ingestion history (eg, raw/contaminated foods, food poisoning)
- Water exposure (eg, swimming pools, marine environment)
- Camping history (possible exposure to contaminated water sources)
- Travel history (common pathogens affect specific regions; also consider rotavirus
andShigella, Salmonella, and Campylobacterspp regardless of specific travel history,
as these organisms are prevalent worldwide)
- Animal exposure (eg, young dogs/cats:Campylobacterspp; turtles: Salmonellaspp)
TREATMENTS FOR DYSENTERY

Rehydration therapy- initially this is done using oral rehydration; the patient is encouraged
to drink plenty of liquids. Diarrhea, as well as vomiting results in loss of fluids that have to be
replaced to preventdehydration. If the diarrhea and/or vomiting is profuse the medical team
may recommend intravenous fluid replacement - the patient will be on a drip.
Antibiotics and amoebicidal drugs- experts say that if possible, the administration of
medications to kill the cause of the dysentery should be held back until lab tests determine
whether the illness is being caused by a bacterium or amoeba. If this is not possible,
depending on the severity of symptoms, the patient may be given a combinations
ofantibioticand amoebicidal medication.
If symptoms are not severe and the doctor determines it is Bacillary dysentery(Shigella), the
patient most likely will receive no medication - in the vast majority of cases the illness will
resolve within a week. Oral rehydration is important.
If amoebic dysentery is diagnosed the patient will probably start with a 10-day course of an
antimicrobial medication, such as Flagyl (metronidazole). Diloxanide furoate, paromomycin
(Humatin), or iodoquinol (Yodoxin) may also be prescribed to make sure the amoeba does not
survive inside the body after symptoms have gone.
TREATMENTS FOR DYSENTERY

Antiparasitic medications such as metronidazole and
iodoquinol, are commonly used to treat dysentery caused
by amoebiasis.Antibiotics like ciprofloxacin, ofloxacin,
levofloxacin, or azithromycin are used to treat the organisms
causing bacillary dysentery. People with prolonged diarrhea should
consult with their doctor. If you travel, you should carry a one- to
three-day self-treatment antibiotic regimen such as ciprofloxacin
and use it in the case of sudden moderate-to-severe diarrheal
illness. Bismuth subsalicylate (Pepto-Bismol) can also be helpful
for some travelers. In addition, use the antidiarrheal medication
loperamide to slow the bowel and prevent dehydration. Consult
your doctor for children under 2 years of age.
RESEARCH
Vaccines currently in development may eventually become a critical part of
the strategy to reduce the incidence and severity of diarrhea, particularly
among children in low-resource settings. For example, Shigella is a
longstanding World Health Organization (WHO) target for vaccine
development, and sharp declines in age-specific diarrhea/dysentery attack
rates for this pathogen indicate that natural immunity does develop following
exposure; thus, vaccination to prevent this disease should be feasible.
Currently, no licensed vaccine targeting Shigella exists. The development of
vaccines against these types of infection has been hampered by technical
constraints, insufficient support for coordination, and a lack of market forces
for research and development. Most vaccine development efforts are taking
place in the public sector or as research programs within biotechnology
companies. Several vaccine candidates are currently in various phases of
research and development, including a number of ongoing clinical trials
SOURCES
Frey, Rebecca. "Dysentery." Gale Encyclopedia of Medicine, 3rd ed.. 2006.
Retrieved January 28, 2016 from Encyclopedia.com:
http://www.encyclopedia.com/doc/1G2-3451600534.html
Medbroadcast.com,. (2016).Dysentery - Causes, Symptoms, Treatment,
Diagnosis - Conditions - MedBroadcast. Retrieved 28 January 2016, from
http://www.medbroadcast.com/Condition/GetCondition/D
Ruiz-Palacios, G., Prez-Schael, I., Velzquez, F., Abate, H., Breuer, T., &
Clemens, S. et al. (2006). Safety and Efficacy of an Attenuated Vaccine
against Severe Rotavirus Gastroenteritis.New England Journal Of
Medicine,354(1), 11-22. http://dx.doi.org/10.1056/nejmoa052434ysentery
Medical News Today,. (2015).Dysentery: Causes, Symptoms and
Treatments. Retrieved 28 January 2016, from
http://www.medicalnewstoday.com/articles/171193.php

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DYSENTE

THERE ARE TWO MAIN

DID YOU KNOW?

Dysentery caused by parasitic worms

Having sex that involves anal contact may spread amoebic

SIGNS AND SYMPTOMS

IF YOU'RE TRAVELLING TO A COUNTRY WHERE THERE

TREATMENTS FOR DYSENTERY

TREATMENTS FOR DYSENTERY

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