DYSENTERY, BACILLARY (Shigellosis) |
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DYSENTERY, BACILLARY (Shigellosis)
DESCRIPTIONBacillary dysentery is 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 3-day incubation period. The lower small intestine (ileum) and large intestine (colon) are involved.
Appropriate health care includes:
Home care.
Physician's monitoring of general condition and medications.
Hospitalization of persons (especially small children with dehydration) who are severely ill. Hospital care will include isolation and intravenous fluid supplements.
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, a germ that invades the lining of the colon. It spreads from person to person, usually from contaminated hands to mouth.
RISK FACTORS
Travel to foreign countries.
Crowded or unsanitary living conditions.
PREVENTING COMPLICATIONS OR RECURRENCE
Urge your child to wash hands after bowel movements and before handling food.
Isolate your child with symptoms of bacillary dysentery.
Immerse your child's soiled clothes and bedclothes in covered buckets of soap and water until they can be boiled.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory stool culture; blood counts.
POSSIBLE COMPLICATIONS
Dangerous dehydration, especially in children.
In rare cases, the bacteria may enter the child's bloodstream from the digestive tract and infect other body organs, such as the kidneys, gallbladder, liver, or heart, and the 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.
TREATMENT
HOME CAREIsolate your child from other people; use a heating pad or hot-water bottle on the child's abdomen to relieve pain.
MEDICATION
Your doctor may prescribe antibiotics, such as ampicillin or trimethoprim with sulfamethoxazole.
Don't give your child paregoric preparations or other anti-diarrhea drugs unless your doctor prescribes them. These may prolong the illness. If they must be used, discontinue them as soon as possible.
ACTIVITY
Your child must rest in bed, except for trips to the bathroom, until fever, diarrhea, and other symptoms have been gone for at least 3 days. The child's legs should be exercised regularly in bed.
DIET & FLUIDS
Your child should be on a liquid or soft diet until the diarrhea stops, then return to a normal diet. For infants and children, see diet instructions in Gastroenteritis in Infants & Children (in Illnesses section).
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has 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 child's sputum; severe abdominal pain or abdominal swelling; rectal bleeding; pain in the child's calf or leg; swollen joints; signs of dehydration (lethargy, sunken eyes, rapid weight loss or dry skin) appear in your child.
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