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Dysentery

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Dysentery is an illness involving severe diarrhea that is often associated with blood in the feces. It is caused by ingestion of food containing microorganisms, causing a disease in which inflammation of the intestines affect the body significantly. There are two major types: shigellosis, which is caused by one of several types of Shigella bacteria; and amoebic dysentery, which is caused by the amoeba Entamoeba histolytica.

In 1898, the same year that the United States declared war on Spain over Cuba and H. G. Wells wrote The War of the Worlds, Shiga discovered the dysentery bacteria.

Etiology

Shigellosis

A patient with shigellosis will often recover without antibiotic treatment. However, treatment by antibiotics is usually recommended because the disease is relatively severe, and it is highly contagious. It can be transmitted by "fomites", for example clothes, doorknobs, toilet seats, etc. The antibiotics norfloxacin, ampicillin and co-trimoxazole may be used. Hospitalization may be required if the disease becomes serious.

See shigellosis for more information.

Amoebic dysentery

Amoebic dysentery is transmitted by contaminated water, and is well known as a "travelers dysentery" because of its prevalence in developing nations, or "Montezuma's Revenge" (particularly in Mexico), although it is occasionally seen in industrialized countries. Liver infection, and subsequent amoebic abscesses can occur. It can be treated with metronidazole or related azole drugs.

Symptoms

The main symptom of epidemic dysentery is bloody diarrhea. Other common symptoms include abdominal cramps, fever and rectal pain. Less frequent complications can include a form of blood poisoning known as sepsis, seizure and kidney failure.

Tiny organisms are spread through contaminated food and water when either is swallowed. From ingestion, they move into the intestines via the stomach. Amoebae spread by forming infective cysts which can be found in stools and spread if whoever touches it does not wash their hands. There are also free amoebae, or “trophozoites”, that do not form cysts. Symptoms are most likely to appear in places with poor hygeine.

Treatment

In adults, dysentery caused by bacteria usually subsides spontaneously. But in children, and other vulnerable groups, the condition can be treated with antibiotics. However, Shigella dysenteriae type 1 (Sd1) has, in recent years, become increasingly resistant to drug treatments. Among people who have become dehydrated as a result of the disease, the key is to replenish their fluid stocks as quickly as possible. This can be done using oral rehydration salts or intravenous fluids. Amoebic dysentery is usually treated with a combination of drugs. These include an amoebicide to kill the parasite, an antibiotic to treat any associated bacterial infection, and a drug to combat infection of the liver and other tissues.

Cultural significance

 


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