Atypical forms of shigellosis;

· Subclinical form (all clinical signs are absent. Changes in mucosal membrane revealed in endoscopy)

· Healthy carrier states (all clinical and morphological signs are absent. Not dangerous for carrier but dangerous for others and can be the source of infection)

Etiology; Shigella Zonei

Shigella Flexnor

Shigella Gigori Shiga

Most severe is dysentery with Flexinor

Source of infection is man (affected or ill person)

Way of spread: Faecal – oral

Unwashed fruits and vegetables, milk

Transmission; In water (unboiled), food

Intoxication period; 1 – 7 days

(depends on amount of microbe)

With direct contact incubation is prolonged

Methods of investigation:

· Culture of feaces (without blood) on Ploskiref medium

· No bacterium; in dysentery – thus cannot receive shigella in blood culture

· Serological method – indirect haemagglutination (Antibodies to shigella)

· Cuprological investigation of faeces

· Rectoromanoscopy (for differential diagnosis in non specific colitis, Crohns disease, Tumors. And also to see decreased inflammation because that is the way to we will know that he has recovered because signs will be absent due to medicines

Amoebic dysentery difference with shigella dysentery

Amoeba	Shigella
Normal temperature (Subfebrile) Caecum involvement Tenesmus is not typical Raspberry jelly faeces (mucous and blood mixed) Extra intestinal manifestations Abscess of different regions (liver, lungs) Therefore increased liver size Can transform to chronic form often	Acute Blood and mucous separate in faeces

Treatment of patients with shigellosis

· Rehydration therapy (electrolytes and fluid)

Intravenous: Asesol solution

Glucose solution

Vatrosol

Disol (without K)

Phillips solution No. 1 and 2 (without K)

Per os: Mineral water

Regidrone

Sitroglucasalone

Oralith

· Detoxication; Asorbants – Microcrystaleized sellelos

· Atriotropic therapy – Antibiotics (dose depends on stage on severity)

Light – Nutrofurans

Moderate – Tocirolones or Siplocks PO and Aminoglycosides - Gentamycin IM 80 mg 3 x /5 days

Severe – Tocinolones IV 10 – 13 days treatment

These leads to disbacteriosis

Therefore after antibiotic treatment restore useful microbes;

Bactisuptide remedies

Bifidum

Holibacterine (only adults)

Lactobaterine

10 days for 1 month

· Herbal treatment; to stimulate mucosal membrane

Дата добавления: 2015-11-14