®

Program MCPS/MRCGP/CEFM CME ©

Course Paediatrics

Module GI

Topic Dysentery

Credit Hours 1 CME credit hour

Total
Educational 2 educational hours
hours

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

®
©
Prof. Nasir Shah
MCPS, FCPS, MRCGP [INT], FRCGP [INT]

Dean Family Medicine Faculty, College of Physicians and

Surgeons Pakistan

Convener National Family Medicine Committee of

Pakistan

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

1
WHO: DEFINITION OF DYSENTERY ®
©
• Dysentery is bloody diarrhea
• Any diarrheal episode in which the loose or watery stools
contain visible red blood.

• Caused by;
1. Bacteria
2. Protozoa
3. Parasitic worms
4. Inflammation

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

DIFFERENTIAL DIAGNOSIS OF DYSENTERY ®

©
1. Amebiasis
2. Bacterial Gastroenteritis
3. Campylobacter/ Yersinia Infections
4. Salmonella Infection (Salmonellosis)
5. Crohn Disease
6. Ulcerative Colitis
7. Rectal polyp

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

2
DIFFERENTIAL DIAGNOSIS ®
©
• Amebiasis

• Blood, tenesmus
• NO fever

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

DIFFERENTIAL DIAGNOSIS ®
©
• Crohn Disease and Ulcerative Colitis

• Bloody mucopurulent diarrhea

• Cramping abdominal pain
• Urgency to defecate
• Backpain
• Systemic symptoms

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

3
DIFFERENTIAL DIAGNOSIS ®
©
• Rectal polyp

• Fresh blood
• NO fever
• NO pain

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

DYSENTERY: ORGANISMS ®
©
• Diarrhea accompanied by fever, bloody or mucoid stools,
severe abdominal cramping or tenderness, or signs of sepsis,
think of
1. Salmonella
2. Shigella
3. Campylobacter
4. Yersinia
5. Clostridium difficile
6. ETEC

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

4
DYSENTERY: SOURCES OF INFECTIOUS DIARRHEA ®
©
Consumption of;

1. Shellfish
2. Raw milk
3. Unpasteurized juice
4. Undercooked meats, fish, or eggs
5. Contaminated fruits or vegetables

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

SHELFISH ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

5
RAW MILK ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

UNPASTEURIZED JUICE ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

6
UNCOOKED MEAT ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

UNCOOKED EGGS ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

7
UNCOOKED FISH ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

CONTAMINATED FRUITS ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

8
CONTAMINATED VEGETABLES ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery

CONTAMINATED VEGETABLES ®
©

MCPS-MRCGP[INT]-CEFM | Pediatrics | GI | Dysentery