Bacillary Dysentery – Shigella infection

Dysentery is most often caused by shigella bacteria (shigellosis) or an amoeba. Dysentery is usually spread through contaminated food or water. Dysentery is an infection of the intestinal tract and is associated with severe diarrhea.

Bacillary dysentery is a gastrointestinal illness or gastroenteritis infection caused by Shigella bacteria which can be found in the human gut.

This infection may be asymptomatic or present with abdominal pain, diarrhea, or dysentery.

A key symptom is bloody diarrhea and also abdominal cramps, abdominal pain, fever, and malaise.

Summary – Bacillary dysentery is the most common type of dysentery. It is an intestinal infection. The causative agent of bacillary dysentery is bacteria called Shigella bacteria.

Shigella bacteria cause an infection, a disease called shigellosis. The main symptom of shigella infection is diarrhea, which often is bloody. Shigella is a highly contagious infection.

bloody diarrhoea symptom required Prompt medical care. Treatment may include increased fluid intake, IV therapy, rehydration solutions, IV fluids, and antibiotics.

Dysentery and Diarrhoea

Bacillary dysentery should not be confused with diarrhea that can be caused by other bacterial infections. One sign of bacillary dysentery is blood in stool, which is the result of an invasion of the mucosa by the pathogen.

Epidemiology Triad

Agent-  The causative agent of  Bacillary dysentery is a group of Shigella bacteria species, family Enterobacteriaceae, which can be found in the human gut.

Host–  Humans are the primary reservoir of Shigella species

Environment – Poor sanitary conditions, contaminated food or water

Mode of Transmission

Portal of entry – fecal-oral route

1. Transmitted directly by physical contact with the faecal material of a patient or carrier (including during sexual contact)

2. Through of Ingestion contaminated food and water.

3. Infection may occur after consuming a small number of the bacteria due to poor sanitary conditions.

4. Consumption of faecal contaminated food or water

5. Occur through person to person contact

 Incubation Period

The incubation period is usually 1 – 3 days, but can be up to 7 days.

Most individual with Shigella infection have diarrhoea (sometimes present blood), fever, and abdominal cramps and the symptoms of infection  usually begin 1–2 days after infection and last 7 days.

Causes of Bacillary Dysentery

Bacillary Dysentery infection route of entry is a fecal-oral route, caused by bacteria called Shigella.

Transmission occurs through ingestion of contaminated food and water and is also transmitted during oral-anal sexual contact, because of fecal material or carrier

Pathophysiology of Bacillary Dysentery

1. Bacillary Dysentery infection transmission is a fecal-oral route, usually ingestion contaminated food, and water.

2. Bacteria reached into in gastrointestinal tract

3. Dysentery is caused when the bacteria escape the epithelial cell phagolysosome, multiply within the cytoplasm, and Shigella bacteria invade the intestinal mucosal cells, destroy host cells.

4. Bacteria produced “Shiga toxin” causes hemorrhagic colitis and hemolytic-uremic syndrome

Hemorrhagic colitis caused by damaging endothelial cells in the microvasculature of the colon and hemolytic-uremic syndrome caused by damaging endothelial cells in the microvasculature of the the glomeruli.

Clinical Manifestation

1. Abdominal cramps/Abdominal pain

2. Diarrhoea

3. Nausea or Vomiting

4. Tenesmus – cramping rectal pain

5. Painful straining with the urge to pass stool

6. Bloody stool or dysentery- stool may contain blood and mucus

7. Fever

 Laboratory Diagnosis

1. Stool (poop) specimen

2. Culture

3. Blood test

Treatment of Bacillary Dysentery

1. Oral rehydration therapy – oral rehydrating solution, patient should drink plenty of fluids to prevent dehydration.

2. Intravenous fluid replacement

3.  Antibiotic therapy – In severe cases administer antibiotic to treat bacterial infection.

Beta-lactams – Ampicillin, amoxicillin

Quinolones: Nalidixic acid, ciprofloxacin, norfloxacin, and ofloxacin

Macrolides: Azithromycin

Prevention and Control

1. Early diagnostic and treatment

2. Hygienic food

3. Handwashing with soap properly before eating or handling food, and after using the toilet

4. Cook food thoroughly before consumption

5. Safe drinking water

6. Environment sanitation

Complications of Bacillary Dysentery

1. Severe Dehydration

Frequent diarrhea and vomiting can quickly lead to dehydration.  For infants and young children, this can become life-threatening or fatal.

2. Liver abscess

If bacteria spread to the liver, they can form a liver abscess.

3. Postinfectious arthritis

Joint pain may occur due to infection.

4. Hemolytic uremic syndrome

Shigella dysentery can cause inflammation and damage the blood vessels in the kidneys. It results in a low red blood cell count (anemia) and also causes the destruction of blood platelets (cells involved in clotting) and kidney failure.

What is the difference between Bacillary Dysentery and Amoebic Dysentery?

Bacillary dysentery is a type of dysentery and a severe form of shigellosis caused by bacteria called Shigella. 

Amebic dysentery or Amebiasis is caused by an amoeba called Entamoeba histolytica.

In most people, Bacillary dysentery is the most common type of dysentery. The disease is called shigellosis.

Amoebic dysentery disease is called amebiasis.

What’s the difference between Dysentery and Diarrhea?

Bacillary dysentery should not be confused with diarrhea caused by other bacterial infections. One key characteristic of bacillary dysentery is presence of blood in stool, called bloody diarrhoea, which is the result of invasion of the mucosa by the pathogen.

Diarrhea is a condition that involves the frequent passing of loose stools or watery stools while Dysentery is an intestinal inflammation, especially in the colon, that can lead to severe diarrhea with mucus or blood in the feces.

Note – Diarrhoea also caused by the Bacterium called Vibrio cholerae causes Cholera infection. Bacterium Vibrio cholerae produces toxins in the small intestine, it cause deadly effects.

The toxin causes the body to secrete in Large amounts of water, leading to diarrhea and a rapid loss of fluids and salts (body fluids; electrolytes).