Dysentery is a human infectious disease that is caused by bacteria belonging to the genus Shigella and occurs with a predominant involvement in the inflammatory process of the lower part of the large intestine and signs of general intoxication.
How do you get dysentery?Dysentery is a typical representative of intestinal infections. The only source of infection is a sick person, who is dangerous to others from the 1st day of illness, since the release of the pathogen into the environment during this period is most intense. They are infected mainly through household contact, water and nutritional (oral) routes.
Predisposing factors for infection are overcrowding of the population in residential premises and low hygienic levels.
Everyone suffers from dysentery, but the vast majority of patients are children under 4 years of age (60% of the incidence). After an illness, a very short-term (4-12 months) immunity is formed. There is always the possibility of relapse. The entry gate of infection is the gastrointestinal tract - the place of entry and reproduction of the microbe.
How does the disease manifest?The disease begins to manifest itself 2-3 days after infection; with the food route, this time can be reduced to hours; with contact and household routes, it can extend up to 7 days.
In most cases, the disease begins acutely; sometimes there may be a prodrome in the form of malaise, chills or headache. Depending on the severity, there are mild, moderate, severe and very severe forms.
The most characteristic signs of the disease in the variant of dysentery affecting the large intestine.
The disease, as a rule, begins with the appearance of abdominal pain, followed by stool disorder. Dysentery can begin with general symptoms - weakness, lethargy, fever, headache, etc.
The manifestations of the disease reach their greatest severity on the 2-3rd day of illness.
This form of dysentery is characterized by a predominance of local phenomena. The most complete signs of dysentery are presented in the moderate form of the disease. Characterized by an acute onset, fever with chills (up to 38-39 ° C), which lasts 2-3 days. Worried about weakness, headache, loss of appetite. Intestinal disorders occur in the first 2-3 hours from the onset of the disease and are manifested by discomfort in the lower abdomen, rumbling, periodic, cramping pain in the lower abdomen, the frequency of stool varies from 10 to 20 times a day. The stool initially has a fecal character, then an admixture of mucus and blood appears, the volume of feces decreases, they can take on the appearance of spit - mucus and blood. There is an acute urge to defecate. The skin becomes pale, the tongue becomes covered with a thick brown coating. From the cardiovascular system, rapid heartbeat and decreased blood pressure are noted. The most characteristic signs are spasm and pain when palpating the left iliac region. Duration of intoxicationand for moderate forms of dysentery is 4-5 days. The stool returns to normal by the 8-10th day of illness, but the disease can drag on for up to 3-4 weeks.
The mild form and severe form differ from the moderate form only in the degree of severity of the symptoms.
In mild forms of dysentery, the temperature is either within normal limits or does not rise above 38 °C. The frequency of stool does not exceed 10 times a day. The stool, as a rule, retains its fecal character. Pathological impurities are often mucus. The disease lasts no more than a week.
The severe form is characterized by more pronounced and prolonged intoxication and severe damage to the intestine. The frequency of stools is 35-40 times a day. The phenomena of hemocolitis are very pronounced, in which an admixture of blood appears in the stool.
Gastroenterocolitic (damage to the stomach and the entire intestine) and gastroenteric (damage to only the stomach and small intestine) variant of dysentery is characterized by a short incubation period, a sudden violent onset with the simultaneous development of toxicosis and intestinal manifestations. Vomiting, very frequent bowel movements with copious discharge, and widespread abdominal pain may occur.
With gastroenteritis, there are no signs of damage to the large intestine throughout the entire course of the disease. With gastroenterocolitis, on the 2-3rd day against the background of gastroenteritis, symptoms of colitis appear, which is manifested by a decrease in the amount of feces, the appearance of mucus, blood, and a false urge to defecate.
When carrying the bacteria, there are no manifestations of the disease, but Shigella is shed in feces.
Complications:
• infectious-toxic shock;
• shock from dehydration;
• acute heart failure;
• toxic expansion of the colon;
• peritonitis - inflammation of the peritoneum;
• bleeding from the intestines;
• intestinal perforation;
• dysbacteriosis - disturbance of intestinal microflora;
• myocarditis;
• reactive polyarthritis.
CHRONIC DYSENTERY
The disease lasts more than 3 months and is caused by the presence of the same pathogen in the human body. The general manifestations are weakly expressed. Intestinal disorders are less pronounced than in the acute course, but disturbances from other organs in the form of anemia, hypovitaminosis, severe dysbacteriosis and exhaustion reach a significant degree of severity.
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