Dysentery Patient, Burma Hospital, Siam Art. Dysentery is an inflammatory disease of the intestine, especially of the colon, which always results in severe diarrhea and abdominal pains. The most common form of dysentery is bacillary dysentery, which is typically a mild sickness, causing symptoms normally consisting of mild gut pains and frequent passage of stool or diarrhea. Symptoms normally present themselves after 1-3 days, and are usually no longer present after a week. In extreme cases, dysentery patients may pass more than one liter of fluid per hour. Dysentery results from viral, bacterial, or parasitic infections. These pathogens typically reach the large intestine after entering orally, through ingestion of contaminated food or water, oral contact with contaminated objects or hands, and so on.
Each specific pathogen has its own mechanism or pathogenesis, but in general, the result is damage to the intestinal linings, leading to the inflammatory immune responses. Extensive cellular damage or death is required to cause bleeding. Bacteria can do this either by invading into intestinal mucosa or by secreting toxins that cause cell death. Bacterial infections that cause bloody diarrhea are typically classified as being either invasive or toxogenic. Invasive species cause damage directly by invading into the mucosa. The toxogenic species do not invade, but cause cellular damage by secreting toxins, resulting in bloody diarrhea. Shigella is thought to cause bleeding due to invasion rather than toxin, because even non-toxogenic strains can cause dysentery, but E. Definitions of dysentery can vary by region and by medical specialty. Others define the term more broadly.
These differences in definition must be taken into account when defining mechanisms. Amoebiasis, also known as amoebic dysentery, is caused by an infection from the amoeba Entamoeba histolytica, which is found mainly in tropical areas. When amoebae inside the bowel of an infected person are ready to leave the body, they group together and form a shell that surrounds and protects them. This group of amoebae is known as a cyst, which is then passed out of the person’s body in the feces and can survive outside the body. If hygiene standards are poor — for example, if the person does not dispose of the feces hygienically — then it can contaminate the surroundings, such as nearby food and water. Some strains of Escherichia coli cause bloody diarrhea. The typical culprits are enterohemorrhagic Escherichia coli, of which O157:H7 is the best known.
A clinical diagnosis may be made by taking a history and doing a brief examination. Treatment is usually started without or before confirmation by laboratory analysis. The mouth, skin, and lips may appear dry due to dehydration. Lower abdominal tenderness may also be present. Cultures of stool samples are examined to identify the organism causing dysentery. Usually, several samples must be obtained due to the number of amoebae, which changes daily.
Dysentery is managed by maintaining fluids by using oral rehydration therapy. If this treatment cannot be adequately maintained due to vomiting or the profuseness of diarrhea, hospital admission may be required for intravenous fluid replacement. If shigellosis is suspected and it is not too severe, letting it run its course may be reasonable — usually less than a week. If the case is severe, antibiotics such as ciprofloxacin or TMP-SMX may be useful. Amoebic dysentery is often treated with two antimicrobial drugs such as metronidazole and paromomycin or iodoquinol. The seed, leaves, and bark of the kapok tree have been used in traditional medicine by indigenous peoples of the rainforest regions in America, west-central Africa, and Southeast Asia to treat this disease. With correct treatment, most cases of amoebic and bacterial dysentery subside within 10 days, and most individuals achieve a full recovery within two to four weeks after beginning proper treatment. If the disease is left untreated, the prognosis varies with the immune status of the individual patient and the severity of disease.
Extreme dehydration can delay recovery and significantly raises the risk for serious complications. Insufficient data exists, but Shigella is estimated to have caused the death of 34,000 children under the age of five in 2013, and 40,000 deaths in people over five years of age. Amoebiasis infects over 50 million people each year, of whom 50,000 die. A Red Army soldier dies of dysentery after eating unwashed vegetables. From a health advisory pamphlet given to soldiers. A notable portrayal of dysentery is included in the popular 1971 computer game The Oregon Trail, where dysentery is one of the most common ways to die. 1183 – Henry the Young King died of dysentery at the castle of Martel on June 11 1183.
King John of England died of dysentery at Newark Castle on 18 October 1216. Saint Louis IX of France died of dysentery in Tunis while commanding his troops for the Eighth Crusade on 25 September 1270. King Henry V of England died suddenly on 31 August 1422 at the Château de Vincennes, apparently from dysentery, which he had contracted during the siege of Meaux. Erasmus, Dutch renaissance humanist and theologian. Sir Francis Drake, Vice Admiral, died of dysentery on 28 January 1596 whilst anchored off the coast of Portobelo. Akbar, ruler of the Mughal Empire of South Asia, died of dysentery.
On 3 October 1605, he fell ill with an attack of dysentery, from which he never recovered. Jacques Marquette died of dysentery on his way north from what is today Chicago, traveling to the mission where he intended to spend the rest of his life. Nathaniel Bacon died of dysentery after taking control of Virginia following Bacon’s Rebellion. He is believed to have died in October 1676, allowing Virginia’s ruling elite to regain control. As late as the nineteenth century, the ‘bloody flux’ it is estimated, killed more soldiers and sailors than did combat. Typhus and dysentery decimated Napoleon’s Grande Armée in Russia. Phan Đình Phùng, a Vietnamese revolutionary who led rebel armies against French colonial forces in Vietnam, died of dysentery as the French surrounded his forces on January 21, 1896. The French explorer and writer, Michel Vieuchange, died of dysentery in Agadir on 30 November 1930, on his return from the “forbidden city” of Smara.
He was nursed by his brother, Doctor Jean Vieuchange, who was unable to save him. Although there is currently no vaccine which protects against Shigella infection, several are in development. Vaccination may eventually become a critical part of the strategy to reduce the incidence and severity of diarrhea, particularly among children in low-resource settings. Cholera, a bacterial infection of the small intestine which produces severe diarrhea. Archived from the original on 5 December 2014. Interventions in diarrheas of infants and young children”. Archived from the original on 14 July 2011.
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