Bacilliary dysentery
Bacilliary dysentery
• Definition
• Bacilliary dysentery is a
diarrhoeal illness
caused by
• Shigella infection
• Aetiology
• There are four species of
Shigella known to cause
diarrhoeal illness:
• Shigella sonnei (75% of UK
infections) cause most of the
mild infections.
• Shigella flexneri and Shigella
boydii (travellers) cause
intermediate infections.
• Shigella dysenteriae is the
most serious.
• Pathophysiology • The organism attaches
• Shigella is a human to the mucosal
pathogen without an epithelium of the distal
animal reservoir. ileum and colon causing
• Spread is by person-to- inflammation and
person contact, faecal– ulceration.
oral route or
contaminated food.
• The incubation period
is usually 2 days.
• Clinical features
• Acute watery diarrhoea with
systemic symptomsof fever,
malaise and abdominal pain
develops into bloody
diarrhoea.
• Other features include nausea,
vomiting and headaches.
• Complications include colonic
perforation, septicaemia,
arthritis and convulsions
• Investigations
• Diagnosis is made on
stool culture.
• Sigmoidoscopy if
performed reveals an
inflamed mucosa with
ulceration similar to
that seen in
inflammatory bowel
disease
• Management
• Treatment is
symptomatic.
• Severe cases may be
treated with
trimethoprim or
ciprofloxacin.
• Outbreaks may occur
and require notification
and source isolation