Dysentery

Bacillary dysentery, or shigellosis, is an intestinal infectious disease caused by Shigella. After infecting the digestive tract, Shigella causes colonic mucosal inflammation and ulcers and releases toxins into the blood. Main clinical manifestations are fever, abdominal pain, diarrhea, tenesmus, and mucoid bloody purulent stool, with systemic toxemia; severe cases may develop septic shock and/or toxic encephalopathy. Shigellosis occurs year-round with peaks in summer and autumn, and is a common, frequently occurring disease in China. Children and young adults are high-risk groups. In traditional Chinese medicine it is called intestinal bi or zhixia. Cases with high fever, coma, and convulsions are called epidemic toxic dysentery, caused by damp-heat evils injuring the spleen and stomach, impairing transportation and transformation, with accumulation brewing in the intestine.

Common Symptoms

Abdominal pain with bloody stool; abnormal stool; diarrhea; porridge-like diarrhea; abdominal pain; black stool with blood; convulsions

Causes and Pathogenesis

Etiology: The pathogen of bacillary dysentery is Shigella, a facultative anaerobic Gram-negative bacillus of the family Enterobacteriaceae, with pili, no flagella, capsule, or spores, non-motile, growing best aerobically. By antigenic structure and biochemical reactions, Shigella is divided into 4 groups (S. dysenteriae, S. flexneri, S. boydii, S. sonnei) and 51 serotypes. In China, S. flexneri and S. sonnei predominate; S. dysenteriae still circulates in some areas. The genus survives well in the external environment, with S. sonnei most hardy and S. dysenteriae least. It is killed by 30 min sunlight, 10 min at 60°C, or instantly at 100°C. Common disinfectants such as Lysol, bleach, benzalkonium bromide, and peracetic acid inactivate it. All Shigella produce endotoxin and exotoxin. Endotoxin causes systemic reactions such as fever, toxemia, septic shock, and organ failure. Exotoxins include enterotoxin, neurotoxin, and cytotoxin, causing corresponding clinical symptoms. Epidemiology: Dysentery occurs year-round but peaks in summer and autumn. Patients and carriers are the source of infection; mild, chronic, and healthy carriers are easily overlooked. Transmission is mainly fecal-oral; children with poor hygiene are susceptible. Pediatric chronic shigellosis is often occult, atypical, and protracted, easily spreading among children. Immunity after infection is not durable, and reinfection occurs. Cold exposure, fatigue, improper diet, malnutrition, and intestinal flora imbalance all reduce resistance.

Treatment

Drug therapy, traditional Chinese medicine, supportive therapy

Preventive Measures

To prevent dysentery: 1. Early detection and effective isolation and thorough treatment of patients and carriers until stool cultures are negative. Focus on monitoring food, childcare, and water workers; infected individuals should be immediately isolated and treated thoroughly. Chronic patients and carriers must not work in these industries. 2. Maintain environmental hygiene, strengthen toilet and feces management, eliminate fly breeding sites, and strengthen food and water source management, especially hygiene supervision of street vendors. 3. Cooks and childcare workers should undergo regular stool examinations and bacterial cultures. Strengthen health education: wash hands before meals and after using the toilet, do not drink raw water, do not eat spoiled or rotten food, and avoid overeating to maintain gastrointestinal resistance.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.