BACILLARY/DESENTERY

• Bacillary dysentery


  Also known as Shigellosis or Bloody Flux
• Etiologic agents


  • Shigella sonnei
  • Shigella flexneri
  • Shigella boydii
  • Shigella dysenteriae
• Incubation period


  12 to 96 hours, but may be up to 1 week
• Period of communicability


  The patient can transmit the microorganism during the acute infection until the feces are negative of the organism
• Modes of transmission


  • Ingestion of contaminated food
  • Drinking contaminated water/milk
  • Feco-oral transmission
• Clinical manifestations


  • Fever
  • Tenesmus
  • Nausea/Vomiting
  • Headache
  • Colicky or cramping abdominal pain associated with anorexia and body weakness
  • Bloody-mucoid stool
  • Rapid dehydration
• Diagnostic tests


  • Microscopic examination of a fresh stool specimen may reveal mucus, red blood cells, and polymorphonuclear leukocytes
  • Direct immunofluorescence with specific antisera will demonstrate Shigella
  • Sigmoidoscopy or proctoscopy may reveal typical superficial ulcerations
  • Stool culture must rule out other causes of diarrhea, such as enteropathogenic Escherichia coli infection, malabsorption disease, and amebic or viral diseases
• Treatment modalities


  • Antibiotics (Ampicillin, Ceftriaxone, Trimethoprim-sulfamethoxazole, Ciprofloxacin)
  • IV Therapy
  • Low Residue Diet
  • Contraindicated: Anti-diarrheal drugs (they delay fecal excretion that can lead to prolong fever)
• Prevention and control


  • Sanitary disposal of human feces
  • Adequate personal hygiene, particularly handwashing after defecation
  • Sanitary supervision of processing, preparation and serving of food (raw)
  • Fly control and protection against fly contamination
  • Isolation (Acute Stage)
  • Protection and purification of public water supply
  • Routine cooking kills shigella