Shigellosis ( bacterial shigellosis )

Infections of GIT

Diarrhea is frequent passage of unformed stools. Acute diarrhea is of abrupt onset and of short duration

Mechanism of diarrhea

There are 4 large groups:

Osmotic

Secretory

Inflammatory

Motility related

In infectious disease of GIT 2 types; inflammatory and secretory are included

· Secretory diarrhea is toxin medicated and doesn’t involve disruption of mucosa. Eg: in vibrio cholera is the usual prototype of toxigenic diarrhea

· Inflammatory diarrhea is caused by infectious agents and involves the mucosal invasions as elements

Character of stool and distinguish faeces;

Large volume watery stool, pus and blood absent – enteritis (small intestine)

Frequent small volume, pus and blood present –

A. Colitis (large intestine) Leucocytes and erythrocytes in Cuprogramme; stool is frequent, small volume, pus or blood.

Infectious disease with colitis -

Shigellosis

Salmonellosis

Amoebiasis

Blantidiasis

Pain in right and left sigmoid and caecum areas

B. Enteritis or small intestine infection

Diseases - Cholera Lambiliosis Shigellosis Salmonellos E – Coli Cryptosporidium

C. Gastroenteritis; Large volume stool and vomiting.

Seen in: Cholera Salmonellosi Lambiliosis

Food poisoning

Acute diarrhea - Bacterial,Fungal,Protozoal, Viral

GIT infections

A. Main syndromes:

a. Gastritis

b. Enteritis

c. Colitis

d. Gastroenteritis

e. Enterocolitis

f. Gastroenterocolitis

B. Syndrome of intoxication

a. Fever

b. Chills

c. Headache

d. General malaise

Can occur without intoxications;

Cholera

Food poisoning

Botulism

C. Syndrome of dehydration:

3 (4) stages of dehydration (isotonic type in GIT infections)

· Thirst

Dryness of oral cavity

2 – 3 % loss of water

These are the 1^st signs

· Tachycardia

Virtigo

Cramps (↓ K, ↓ Ca)

Oliguria

These are the 2^nd signs

· Severe muscle cramps

Hoarse voice (aphonia)

Anemia

The 3^rd signs

Cholera

Syndrome of cholera - Enteritis or gastroenteritis

Diarrhoea not due to inflammation

Toxins by vibrio cholera affect adenocyclase system

Increased peristalsis gives diarrhea

Without intoxication

Shigellosis (bacterial shigellosis)

2 main clinical forms according to syndromes

1. Gastroenteritic form

2. Colitic form

Also intoxication syndrome can occur;

Collapse

Weakness

Fever

Headache

Diarrhea

These symptoms are in colitic form

Dehydration syndrome cannot occur in colitic form

Therefore criteria of severity in colitic form

A. Frequency of stool: > 30 times / day – severe

10 – 30 times / day – moderate

< 10 times / day – light

B. According to intoxication: Temperature

> 39 – 40 *C – Severe

< 38 * C – Light

Gastroenteritic form; syndrome of dehydration can occur

Other clinical forms of shigellosis

1. Acute (above 2 forms)

2. Chronic; gastroenteritic form with relapses or colitic form with constant diarrhea

Дата добавления: 2015-11-14