Bacillary dysentery

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Bacillary dysentery
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Bacillary dysentery is a type of dysentery, and is a severe form of shigellosis.

Dysentery inflammation of the intestine causing diarrhea with blood

Dysentery is an inflammatory disease of the intestine, especially of the colon, which always results in severe diarrhea and abdominal pains. Other symptoms may include fever and a feeling of incomplete defecation. The disease is caused by several types of infectious pathogens such as bacteria, viruses and parasites.

Shigellosis Human disease

Shigellosis is an infection of the intestines caused by Shigella bacteria. Symptoms generally start one to two days after exposure and include diarrhea, fever, abdominal pain, and feeling the need to pass stools even when the bowels are empty. The diarrhea may be bloody. Symptoms typically last five to seven days. Complications can include reactive arthritis, sepsis, seizures, and hemolytic uremic syndrome.

Contents

Bacillary dysentery is associated with species of bacteria from the Enterobacteriaceae family. [1] The term is usually restricted to Shigella infections. [2]

Enterobacteriaceae family of bacteria

The Enterobacteriaceae are a large family of Gram-negative bacteria. This family is the only representative in the order Enterobacteriales of the class Gammaproteobacteria in the phylum Proteobacteria.

<i>Shigella</i> genus of bacteria

Shigella is a genus of Gram-negative, facultative aerobic, non-spore-forming, nonmotile, rod-shaped bacteria genetically closely related to E. coli. The genus is named after Kiyoshi Shiga, who first discovered it in 1897.

Shigellosis is caused by one of several types of Shigella bacteria. [3] Three species are associated with bacillary dysentery: Shigella sonnei, Shigella flexneri and Shigella dysenteriae . [4] A study in China indicated that Shigella flexneri 2a was the most common serotype. [5]

<i>Shigella sonnei</i> species of bacterium

Shigella sonnei is a species of Shigella. Together with Shigella flexneri, it is responsible for 90% of shigellosis cases. Shigella sonnei is named for the Danish bacteriologist Carl Olaf Sonne. It is a Gram-negative, rod-shaped, nonmotile, non-spore-forming bacterium.

<i>Shigella flexneri</i> species of bacterium

Shigella flexneri is a species of Gram-negative bacteria in the genus Shigella that can cause diarrhea in humans. Several different serogroups of Shigella are described; S. flexneri belongs to group B. S. flexneri infections can usually be treated with antibiotics, although some strains have become resistant. Less severe cases are not usually treated because they become more resistant in the future.

<i>Shigella dysenteriae</i> species of bacterium

Shigella dysenteriae is a species of the rod-shaped bacterial genus Shigella. Shigella species can cause shigellosis. Shigellae are Gram-negative, non-spore-forming, facultatively anaerobic, nonmotile bacteria.S. dysenteriae has the ability to invade and replicate in various species of epithelial cells and enterocytes.

Salmonellosis caused by Salmonella enterica (serovar Typhimurium) has also been described as a cause of bacillary dysentery,[ citation needed ] though this definition is less common. It is sometimes listed as an explicit differential diagnosis of bacillary dysentery, as opposed to a cause. [6]

Salmonellosis infection caused by Salmonella bacteria

Salmonellosis is a symptomatic infection caused by bacteria of the Salmonella type. The most common symptoms are diarrhea, fever, abdominal cramps, and vomiting. Symptoms typically occur between 12 hours and 36 hours after exposure, and last from two to seven days. Occasionally more significant disease can result in dehydration. The old, young, and others with a weakened immune system are more likely to develop severe disease. Specific types of Salmonella can result in typhoid fever or paratyphoid fever.

<i>Salmonella enterica</i> species of bacterium

Salmonella enterica is a rod-shaped, flagellate, facultative aerobic, Gram-negative bacterium and a species of the genus Salmonella. A number of its serovars are serious human pathogens.

Bacillary dysentery should not be confused with diarrhea caused by other bacterial infections. One characteristic of bacillary dysentery is blood in stool, [7] which is the result of invasion of the mucosa by the pathogen.

Diarrhea Loose or liquid bowel movements

Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are exclusively breastfed, however, are normal.

Blood in stool

Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. Evaluation of the blood found in stool depends on its characteristics, in terms of color, quantity and other features, which can point to its source, however, more serious conditions can present with a mixed picture, or with the form of bleeding that is found in another section of the tract. The term "blood in stool" is usually only used to describe visible blood, and not fecal occult blood, which is found only after physical examination and chemical laboratory testing.

Pathogenesis

Transmission is fecal-oral and is remarkable for the small number of organisms that may cause disease (10 ingested organisms cause illness in 10% of volunteers, and 500 organisms cause disease in 50% of volunteers). Shigella bacteria invade the intestinal mucosal cells but do not usually go beyond the lamina propria. Dysentery is caused when the bacteria escape the epithelial cell phagolysosome, multiply within the cytoplasm, and destroy host cells. Shiga toxin causes hemorrhagic colitis and hemolytic-uremic syndrome by damaging endothelial cells in the microvasculature of the colon and the glomeruli, respectively. In addition, chronic arthritis secondary to S. flexneri infection, called reactive arthritis, may be caused by a bacterial antigen; the occurrence of this syndrome is strongly linked to HLA-B27 genotype, but the immunologic basis of this reaction is not understood.[ citation needed ]

Fecal–oral route Disease transmission via pathogens from fecal particles

The fecal–oral route describes a particular route of transmission of a disease wherein pathogens in fecal particles pass from one person to the mouth of another person. Main causes of fecal–oral disease transmission include lack of adequate sanitation, and poor hygiene practices. If soil or water bodies are polluted with fecal material, humans can be infected with waterborne diseases or soil-transmitted diseases. Fecal contamination of food is another form of fecal-oral transmission. Washing hands properly after changing a baby's diaper or after performing anal hygiene can prevent foodborne illness from spreading.

Colitis inflammation of the colon or the large intestine

Colitis is an inflammation of the colon. Colitis may be acute and self-limited or long-term. It broadly fits into the category of digestive diseases.

Hemolytic-uremic syndrome Human disease

Hemolytic-uremic syndrome (HUS) is a group of blood disorders characterized by low red blood cells, acute kidney failure, and low platelets. Initial symptoms typically include bloody diarrhea, fever, vomiting, and weakness. Kidney problems and low platelets then occur as the diarrhea is improving. While children are more commonly affected adults may have worse outcomes. Complications may include neurological problems and heart failure.

Diagnosis

Specimen: Fresh stool is collected.

Culture: Specimen is inoculated on selective media like MacConkey's agar, DCA, XLD agar. Selenite F broth(0.4%) is used as enrichment medium which permits the rapid growth of enteric pathogens while inhibiting the growth of normal flora like E. coli for 6–8 hours. Subculture is done on the solid media from selenite F broth. All the solid media are incubated at 37 degrees for 24 hours.

Cultural characteristics: Colorless (NLF) colonies appear on MacConkey's agar which are further confirmed by gram staining, hanging drop preparation and biochemical reactions.

Treatment

Dysentery is initially managed by maintaining fluid intake 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. Ideally, no antimicrobial therapy should be administered until microbiological microscopy and culture studies have established the specific infection involved. When laboratory services are not available, it may be necessary to administer a combination of drugs, including an amoebicidal drug to kill the parasite and an antibiotic to treat any associated bacterial infection.

Anyone with bloody diarrhea needs immediate medical help. Treatment often starts with an oral rehydrating solution—water mixed with salt and carbohydrates—to prevent dehydration. (Emergency relief services often distribute inexpensive packets of sugars and mineral salts that can be mixed with clean water and used to restore lifesaving fluids in dehydrated children gravely ill from dysentery.)

If Shigella is suspected and it is not too severe, the doctor may recommend letting it run its course—usually less than a week. The patient will be advised to replace fluids lost through diarrhea. If the infection is severe, the doctor may prescribe antibiotics, such as ciprofloxacin or TMP-SMX (Bactrim). Unfortunately, many strains of Shigella are becoming resistant to common antibiotics, and effective medications are often in short supply in developing countries. If necessary, a doctor may have to reserve antibiotics for those at highest risk for death, including young children, people over 50, and anyone suffering from dehydration or malnutrition.

No vaccine is available. There are several Shigella vaccine candidates in various stages of development that could reduce the incidence of dysentery in endemic countries, as well as in travelers suffering from traveler's diarrhea. [8]

Related Research Articles

Agar plate

An agar plate is a Petri dish that contains agar as a solid growth medium plus nutrients, used to culture microorganisms. Sometimes selective compounds are added to influence growth, such as antibiotics.

<i>Campylobacter jejuni</i> species of bacterium

Campylobacter jejuni is one of the most common causes of food poisoning in Europe and in the United States. The vast majority of cases occur as isolated events, not as part of recognized outbreaks. Active surveillance through the Foodborne Diseases Active Surveillance Network (FoodNet) indicates that about 14 cases are diagnosed each year for each 100,000 persons in the population. The European Food Safety Authority estimated in 2011 that there are approximately nine million cases of human campylobacteriosis per year in the European Union.

Gastroenteritis Inflammation of the stomach and small intestine

Gastroenteritis, also known as infectious diarrhea, is inflammation of the gastrointestinal tract—the stomach and small intestine. Symptoms may include diarrhea, vomiting and abdominal pain. Fever, lack of energy and dehydration may also occur. This typically lasts less than two weeks. It is not related to influenza, though it has been called the "stomach flu".

Campylobacteriosis genus of Gram-negative bacteria

Campylobacteriosis is an infection by the Campylobacter bacterium, most commonly C. jejuni. It is among the most common bacterial infections of humans, often a foodborne illness. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, mostly including cramps, fever and pain.

Travelers diarrhea disease

Traveler's diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage of unformed stool while traveling. It may be accompanied by abdominal cramps, nausea, fever, and bloating. Occasionally bloody diarrhea may occur. Most travelers recover within four days with little or no treatment. About 10% of people may have symptoms for a week.

Reactive arthritis arthritis that is an autoimmune disease which develops due to an infection located elsewhere in the body

Reactive arthritis, formerly known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. By the time the patient presents with symptoms, often the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

Pathogenic bacteria

Pathogenic bacteria are bacteria that can cause disease. This article deals with human pathogenic bacteria. Although most bacteria are harmless or often beneficial, some are pathogenic, with the number of species estimated as fewer than a hundred that are seen to cause infectious diseases in humans. By contrast, several thousand species exist in the human digestive system.

Gastroenterocolitis is a condition characterized by inflammation of the stomach, small intestines, and colon.

Enteroinvasive Escherichia coli (EIEC) is a type of pathogenic bacteria whose infection causes a syndrome that is identical to shigellosis, with profuse diarrhea and high fever. EIEC are highly invasive, and they use adhesin proteins to bind to and enter intestinal cells. They produce no toxins, but severely damage the intestinal wall through mechanical cell destruction.

Pathogenic <i>Escherichia coli</i>

Escherichia coli ( Anglicized to ; commonly abbreviated E. coli) is a gram-negative, rod-shaped bacterium that is commonly found in the lower intestine of warm-blooded organisms (endotherms). Most E. coli strains are harmless, but some serotypes are pathogenic and can cause serious food poisoning in humans, and are occasionally responsible for product recalls. E. coli are also responsible for a majority of cases of urinary tract infections. The harmless strains are part of the normal flora of the gut, and can benefit their hosts by producing vitamin K2, and by preventing the establishment of pathogenic bacteria within the intestine.

In biology, a pathogen, in the oldest and broadest sense, is anything that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ.

Hilleman Laboratories

Hilleman Laboratories is a Delhi-based vaccine research organization. The firm is an equal-joint venture between US drug maker Merck & Co Inc and British charitable foundation Wellcome Trust. The research firm is named in the honour of Dr. Maurice Ralph Hilleman (1919–2005).

References

  1. Dysentery,+Bacillary at the US National Library of Medicine Medical Subject Headings (MeSH)
  2. " bacillary dysentery " at Dorland's Medical Dictionary
  3. Yang F, Yang J, Zhang X, et al. (2005). "Genome dynamics and diversity of Shigella species, the etiologic agents of bacillary dysentery". Nucleic Acids Res. 33 (19): 6445–58. doi:10.1093/nar/gki954. PMC   1278947 . PMID   16275786.
  4. "WHO | Diarrhoeal Diseases". Archived from the original on 15 December 2008. Retrieved 2008-12-19.
  5. Wang XY, Tao F, Xiao D, et al. (July 2006). "Trend and disease burden of bacillary dysentery in China (1991-2000)". Bull. World Health Organ. 84 (7): 561–8. doi:10.2471/BLT.05.023853. PMC   2627389 . PMID   16878230.
  6. "Bacillary Dysentery". Archived from the original on 27 December 2008. Retrieved 2008-12-19.
  7. "Enterobacteriaceae, Vibrio, Campylobacter and Helicobacter". Archived from the original on 24 December 2008. Retrieved 2008-12-19.
  8. Girard MP, Steele D, Chaignat CL, Kieny MP (April 2006). "A review of vaccine research and development: human enteric infections". Vaccine. 24 (15): 2732–50. doi:10.1016/j.vaccine.2005.10.014. PMID   16483695.
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