DYSENTERY, BACILLARY

General Information

DEFINITION--A bacterial infection of the surface layers of the intestinal tract. This is contagious with close personal contact and occurs in epidemics. It has a 1 to 4 day incubation period.

BODY PARTS INVOLVED--Lower small intestine (ileum); large intestine (colon).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Abdominal cramps.
• Fever.
• Diarrhea (up to 20 or 30 watery bowel movements in 1 day).
• Blood, mucus or pus in the stool.
• Nausea or vomiting.
• Muscle aches or pain.
• White-blood-cell count lower than normal at the onset (sometimes).

CAUSES--Bacteria called Shigella bacillus, that invades the lining of the colon. It spreads from person to person, usually from contaminated hands to mouth, contaminated food or drinking water.

RISK INCREASES WITH

• Travel to foreign countries.
• Crowded or unsanitary living conditions.

HOW TO PREVENT

• Wash hands after bowel movements and before handling food.
• Isolate anyone with symptoms of bacillary dysentery.
• Immerse soiled clothes and bedclothes in covered buckets of soap and water until they can be boiled.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory stool culture. Diagnosis is aided by knowledge of outbreaks and endemic areas.

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's treatment.
• Hospitalization of persons (especially small children with dehydration) who are severely ill. Hospital care will include isolation and intravenous fluid supplements.

POSSIBLE COMPLICATIONS

• Dangerous dehydration, especially in children.
• In rare cases, the bacteria may enter the bloodstream from the digestive tract and infect other body organs, such as kidneys, gallbladder, liver or heart and joints. This may cause shock and death.

PROBABLE OUTCOME--Usually curable in 7 days with treatment. Most Shigella infections are mild and don't require drastic treatment. However, in a severe attack, excessive dehydration can be fatal (especially in infants and young children) if treatment is unsuccessful.

How To Treat

GENERAL MEASURES--

• Isolate the patient from others.
• Use a heating pad or hot-water bottle on the abdomen to relieve pain.
• Maintain fluid intake.

MEDICATION--

• Your doctor may prescribe antibiotics.
• Don't use paregoric preparations or other antidiarrhea drugs unless your doctor prescribes them. These may prolong the illness. If used, discontinue them as soon as possible.

ACTIVITY--Bed rest is necessary, except for trips to the bathroom, until fever, diarrhea and other symptoms have been gone for at least 3 days. The legs should be exercised regularly in bed.

DIET--Liquid (use commercial rehydration products) or soft diet until diarrhea stops, then return to normal diet.

Call Your Doctor If

• You or your child have symptoms of bacillary dysentery.
• The following occurs during treatment: Fever of 102F (38.9C) or more. Sore throat, headache or earache. Shortness of breath or severe cough. Traces of blood in the sputum. Severe abdominal pain or abdominal swelling. Rectal bleeding. Pain in the calf or leg. Swollen joints. Signs of dehydration (lethargy, sunken eyes, rapid weight loss or dry skin) appear.