Bacillary Dysentery (Shigellosis)

Bacillary Dysentery (Shigellosis)

An acute bacterial disease involving the large and small intestine characterised by bloody mucoid diarrhoea

Cause

• Shigella dysenteriae

• Shigella flexneri

• Shigella sonnei

All the above are spread by faecal−oral route

Clinical features

• Mucoid bloody diarrhoea

• Fever

• Nausea, vomiting, abdominal cramps

• Tenesmus (sensation of desire to defecate without production of significant amounts of

   faeces)

• Toxaemia (sometimes)

• S. flexneri infection may be complicated with Reiter’s syndrome

Differential diagnosis

• Amoebic dysentery

• Other causes of bloody diarrhoea

Investigations

Stool: for C&S, microscopy

Management

Correct any dehydration

nalidixic acid 1g every 6 hours for 5 days

or ciprofloxacin 1g single dose

child >3mths:

cotrimoxazole

or nalidixic acid 15mg/kg per dose as above

or ciprofloxacin 20mg/kg single dose

Caution

ciprofloxacin, nalidixic acid: contraindicated in pregnancy

− use instead chloramphenicol 500mg every 8 hours for 5 days 

Prevention

- Provide health education of the public on:

-washing hands before eating food

-proper disposal of faeces

-boiling of all drinking water

-avoiding eating cold foods & roadside foods