Dysentery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Dysentery is bloody diarrhoea, i.e. any diarrhoeal episode in which the loose or watery stools contain visible red blood. Dysentery is most often caused by Shigella species (bacillary dysentery) or Entamoeba histolytica (amoebic dysentery).

Insufficient data exists, but conservative estimates from the WHO suggest that 90 million cases of Shigellosis are contracted annually, with at least 100,000 of these resulting in death.^[1] Amebiasis is infecting over 50 million people each year, killing about 50,000.^[2]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Dysentery results from viral infections, bacterial infections, or parasitic infestations. These pathogens typically reach the large intestine after entering orally, through ingestion of contaminated food or water, oral contact with contaminated objects or hands, and so on.

Each specific pathogen has its own mechanism or pathogenesis, but in general the result is damage to the intestinal lining, leading to the inflammatory immune response. This can cause elevated temperature, painful spasms of the intestinal muscles (cramping), swelling due to water leaking from capillaries of the intestine (edema), and further tissue damage by the body’s immune cells and the chemicals, called cytokines, they release to fight the infection. The result can be impaired nutrient absorption, excessive water and mineral loss through the stools due to breakdown of the control mechanisms in the intestinal tissue that normally remove water from the stools, and in severe cases the entry of pathogenic organisms into the bloodstream.

Some microorganisms – for example, bacteria of the genus Shigella – secrete substances known as cytotoxins, which kill and damage intestinal tissue on contact. Viruses directly attack the intestinal cells, taking over their metabolic machinery to make copies of themselves, which leads to cell death.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

• Enterohemorrhagic E. coli (EHEC)
• Campylobacter
• Salmonellaspp.
• Shigella
• Entamoeba histolytica
• Medications – Rifaximin, Sulfasalazine
• Cancer
• Yersinia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Insufficient data exists, but conservative estimates from the WHO suggest that 90 million cases of Shigellosis are contracted annually, with at least 100,000 of these resulting in death.^[1] Amebiasis is infecting over 50 million people each year, killing about 50,000.^[2]

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Please help WikiDoc by adding more content here. It’s easy! Click here to learn about editing.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal.

• Shock
• Delirium
• Hemolytic uremic syndrome: EHECs and shigella that induce bloody diarrhea can lead to HUS. The clinical manifestations of postdiarrheal HUS include acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. The verocytotoxin (shiga-like toxin) can directly damage renal and endothelial cells. Thrombocytopenia occurs as platelets are consumed by clotting. Hemolytic anemia results from intravascular fibrin deposition, increased fragility of red blood cells, and fragmentation.
• Thrombotic thrombocytopenic purpura
• Reactive arthritis

With correct treatment, most cases of amoebic and bacterial dysentery subside within ten days, and most individuals will achieve a full recovery within two to four weeks after beginning proper treatment. If the disease is left untreated, the prognosis varies with the immune status of the individual patient and the severity of disease. Extreme dehydration can prolong recovery and significantly raises the risk for serious complications.^[1]

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