Infectious diseases. Shigellosis (bacterial dysentery) (most important)

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Infectious diseases. Shigellosis (bacterial dysentery) (most important)

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5. Shigellosis (bacterial dysentery)

The disease is an acute inflammatory process in the gastrointestinal tract caused by bacteria from the genus Shigella and characterized by fever, cramping abdominal pain and diarrhea mixed with mucus, pus and blood in the stool.

Etiology. Shigella are short, immobile Gram-negative rods whose biochemical feature is the absence or very slow fermentation of lactose.

Epidemiology. Shigella are common throughout the world.

Man serves as the main reservoir of infection. Ways of infection: contact-household, food, water.

Pathogenesis. Infection with a small number of Shigella (less than 200) is sufficient for the development of the disease. Pathogens remain viable in the acidic environment of gastric contents for 4 hours. The infection develops only when the pathogen penetrates into the epithelial cells of the intestine.

Clinical manifestations. The incubation period depends on the route of infection and the dose of the pathogen and usually ranges from 6-8 hours to 7 days, more often 36-72 hours, during which the Shigella reach the large intestine. Initially, patients complain of fever and cramping abdominal pain. Body temperature can reach 40 ° C, the phenomena of general intoxication intensify. 48 hours after the onset of the disease, diarrhea appears, stools with blood and mucus occur up to 20 times a day. When examining the child, there is a slight soreness of the abdomen on palpation without a clear localization.

At high temperature and convulsions, shigellosis may be accompanied by symptoms of damage to the nervous system, resembling meningitis, encephalitis.

Diagnosis. Dysentery should be suspected in all patients with diarrhea accompanied by fever. The diagnosis of shigellosis is established on the basis of clinical and epidemiological data, with mandatory laboratory confirmation.

For the final diagnosis use:

1) bacteriological method;

2) serological methods;

3) express diagnostic methods;

4) sigmoidoscopy method;

5) scatological method;

6) examination of peripheral blood. Treatment. Significantly when treated with antibiotics

the duration of the disease and the timing of the isolation of shigella are reduced. Prolonged bacteriocarrier develops very rarely. In such cases, lactulose, a derivative of lactose, causes a temporary effect.

Forecast and prevention. In most previously healthy children, shigellosis proceeds favorably and is prone to spontaneous recovery.

Strict adherence to the rules of personal hygiene and sanitary measures are the basis for the prevention of shigellosis.

Author: Pavlova N.V.

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