• Dysentery: symptoms and treatment, signs of dysentery

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    Dysentery is an infectious disease that occurs with a predominant lesion of the large intestine and common toxicosis.

    This disease is a group of acute gastrointestinal infections.

    Dysentery causative agent

    Dysentery causative agents in adults are bacteria from the genus Shigella that belong to the family of enterobacteria. Among them there are four types: shigella dysentery, Grigoriev-Shigi, Sonne and Flexneri. Shigella are represented by immobile gram-negative rods, they do not form spores and capsules.

    Dysentery bacilli can produce exotoxins - enterotoxins, cytotoxins and strong neurotoxins, endotoxin is released upon destruction. These toxic substances cause an intoxication of the body and intestinal damage with the corresponding symptoms.

    The main mechanism of infection with shigella is fecal-oral. It is carried out in three ways - water, contact and food. Infection occurs through a variety of household items, food, water, soil, hands, etc.

    Symptoms of dysentery in adults

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    In the clinical picture of symptoms of dysentery, four stages are distinguished: initial, midsection, extinction and recovery. Usually the disease has an acute onset.

    The first signs of dysentery in adults are:

    • chills;
    • feeling of heat;
    • elevated temperature;
    Fever up to 38-40 degrees is saved from several hours to 5 days. In some cases, the disease occurs with a slight rise in temperature or without fever. Such a picture is observed in weakened persons, elderly people.

    Signs of lesions of the nervous system in dysentery include:

    • weakness;
    • weakness;
    • unstable mood or apathy;
    • headache;
    • lowering blood pressure;
    • heart rhythm disturbances;
    The main manifestation of dysentery is the symptoms of colitis. Patients complain of cutting cramping pain in the abdomen, which is localized in the iliac regions( mostly on the left).

    Pain sensations occur before each defecation and are layered on it. Characteristic is the appearance of tenesmus - a painful urge to defecate. They are manifested by painful drawing pain in the rectum. Most often these desires are sterile, the emptying of the intestine does not bring relief.

    In dysentery, the function of all parts of the gastrointestinal system is impaired. There is dryness in the mouth, the motility of the stomach and intestines changes, the acidity of the digestive juices decreases.

    Also read the symptoms and treatment of intestinal infection.

    The nature of the stool for dysentery

    The frequency of stool in shigellosis can reach thirty times a day, and sometimes more. During each bowel movement, a very small amount of feces is released. The total amount of feces rarely is more than 500 ml per day. At the very beginning of the disease, the stool has a liquid or semi-liquid stool character, often with an admixture of mucus.

    After a while, instead of stool, only transparent thick mucus begins to appear, in which blood appears in the form of veins, and later, pus. Because of this nature, a chair in dysentery is called a "dysenteric spitting".

    The peak period lasts from 2 to 9 days. Then comes the phase of extinction of symptoms. All manifestations gradually weaken and disappear. The recovery period can be delayed up to several weeks. When untimely referral to a doctor, inadequate therapy, functional disorders of the gastrointestinal tract and nervous system may persist for many months.

    People with reduced immunity may have a chronic infection, such persons can become a source of infection for others even if there are no signs of illness.

    Clinical variants of

    In the clinical picture, the following variants of dysentery are distinguished:

    • colitis;
    • gastroenteric;
    • gastroenterocolitis;
    In the colitis variant, the symptoms of colitis predominate, as described above.

    The gastroenteric variant is characterized by signs of gastritis and enteritis. These include nausea and vomiting, abundant stools of a watery consistency.

    With the gastroenterocolitis form of dysentery, the symptoms of gastritis first prevail, then enteritis occurs. Gradually, the stool volume decreases, since colitis is attached. The further course corresponds to the colitis variant.

    Dysentery can take a long( more than two months) or chronic forms. Chronic shigellosis infection is characterized by alternation of periods of exacerbation and remission. Relapses in symptomatology are similar to acute shigellosis. In addition to acute and chronic forms of the disease, shigellosis bacteriocarrier is isolated. In this shigella multiply in the intestine and are released into the environment, but there are no obvious signs of the disease.

    Diagnosis of dysentery

    Diagnosis of dysentery is made on the basis of characteristic complaints and symptoms. Also, in adults, laboratory tests are performed:

    • blood test( the number of leukocytes, in particular of young forms of neutrophils, increases in ESR);
    • urine analysis( in severe cases in the urine find cylinders, protein, erythrocytes);
    • serological examination of blood for the presence of antibodies or bacterial antigens;
    • microscopic and bacteriological study of feces( detect shigella, determine their appearance, sensitivity to antibacterial agents);
    • coprologic examination of feces( feces, clusters of neutrophils, erythrocytes, a large amount of epithelium are found in feces).
    Among the instrumental methods of diagnosis is the use of sigmoidoscopy. Using an optical device, examine the mucous membrane of the rectus and large intestine. Dysentery is characterized by the presence of erosion and ulceration, swelling and redness of the inner shell of the intestine.

    Treatment of dysentery

    With a mild course of acute dysentery, treatment is possible at home. More severe forms, the presence of other associated diseases, suggest hospitalization in an infectious hospital. Hospitalization can also be carried out by epidemiological indications.

    Treatment of shigellosis infection in adults includes:

    • diet( with mechanical and chemical GI traction);
    • bed or half-bed treatment and protection regime;
    • drug therapy.

    Medical treatment

    For etiotropic treatment of dysentery antibacterial agents( levomycetin, nitrofuran derivatives, sulfonamides, fluoroquinolones, aminoglycosides, etc.) are used. With severe intoxication, saline and colloidal solutions are injected intravenously.

    In the recovery period, prescribe vitamins, immunomodulators, enzyme preparations, probiotics( hilak forte, bifidobacterin, colibacterin).For rapid healing of intestinal erosions, methyluracil is used in candles, sea buckthorn oil, fish oil in the form of microclysters.

    Prevention of the disease

    In the prevention of shigellosis in adults, the main role is given to compliance with anti-epidemiological and sanitary-hygienic requirements. All cases of disease are subject to mandatory registration. In the focus of infection, disinfection cleaning is carried out.

    Early detection, hospitalization and treatment of patients are required to prevent the spread of dysentery. The patient is discharged from the hospital after a three-time bacteriological examination, provided that a negative result is obtained.

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