Bacillary Dysentry
exp date isn't null, but text field is
Introduction
- An important cause of diarrhoea, caused by pathogenic species of Shigella A-D (dysenteri, flexneri, boydii and sonnei)
Clinical features
- Mucoid bloody diarrhoea
- Tenesmus
- Abdominal pain
- Pyrexia
Complications
- Septicaemia/bacteraemia
- Severe rectal bleeding
- Intestinal perforation
- Reiter's syndrome
Investigations
- Stool microscopy, culture, and sensitivity
- Full Blood Count
Treatment goals
- Eradicate bacterial pathogens
- Supportive care
Drug treatment
Appropriate systemic antibiotics are required with systemic infections.
- Adults
- Ciprofloxacin 500 mg - 1 g orally 12 hourly for 5 days
- Azithromycin 500 mg daily for 3 days for resistant strains
- Children
- Cotrimoxazole:
- 6 weeks – 6 months: 120 mg every 12 hours
- 6 months – 6 years: 240 mg every 12 hours
- 6 years – 12years: 480 mg every 12 hours
- 12 years - 18 years: 960 mg every 12 hours
- Cotrimoxazole:
Notable Adverse Drug Reactions, Complications and Caution
- Ciprofloxacin causes tendinitis especially in children and so is contraindicated in pregnancy and in children <18 years
Prevention
- Personal and communal hygiene
- Potable water, sanitary disposal of faeces.