Dieseneria: diagnosis and treatment


  • Dysentery
  • How dysentery is manifested
  • How to diagnose dysentery
  • How to treatment with dysentery

  • Dysentery

    Dieseneria - infectious disease characterized by damage to the gastrointestinal tract, predominantly colon.

    Dysentery cause bacteria of Schigella. With the destruction of microbes
    Toxin is distinguished, which plays a big role in the development of the disease and
    determines its manifestations.

    Dysentery pathogens differ in high survival in
    external environment. Depending on the temperature and humidity conditions, they
    persist from 3-4 days to 1-2 months, and in some cases up to 3-4
    months and even more. Under favorable conditions, Schigellas are capable of
    breeding in food (salads, winegrates, boiled meat,
    minced stuffing, boiled fish, milk and dairy products, compotes and kissels).

    Dieseneria is transmitted only from a person through food contaminated by feces, water, as well as in contact.

    The source of the causative agent of infection during dysentery is patients, and
    also bacteria carriers that highlight Shigella to the external environment with
    feces. Patients with dysentery infectious since the beginning of the disease. Duration
    selection of pathogen patients, as a rule, does not exceed the week, but
    can be delayed to 2-3 weeks.

    Dieseneria: diagnosis and treatment
    The greatest sensitivity to infection in persons with a group of blood A (II).

    The leading factor in the development of the disease is the admission of bacterium poisons
    in blood. First of all, the nervous system is affected as well
    Cardiovascular system, adrenal glands and digestive organs.

    Shigella can be in the stomach from several hours to
    several days (in rare cases). Overcome acid barrier
    Stomach, Shigella gets into the intestines. In the small intestine they are attached
    to the intestinal cells and highlight toxin, which causes an increased
    secretion of liquid and salts in the intestinal lumen. Shigella actively
    moved by causing an inflammatory process in a small intestine that
    Supported and exacerbated by the action produced by Schigella
    Toxin. Toxin Shigell, enters the blood and determines the development

    In the colon, Shigella gets somewhat later, but massively. This leads to a more significant action of Shigell toxins.

    Recovery in dysentery is usually accompanied by liberation
    The organism from the pathogen. However, in case of insufficiency of the immune system
    Cleansing the body from the causative agent is dragged up to 1 month and more.
    It is formed by the carriage, and the part of the ill-faced disease acquires
    Chronic flow.

    After the suffering disease, a short immunity is formed.

    The incubation period is 1-7 (on average 2-3) days, but can be reduced to 2-12 hours.

    Form, option and severity of the flow of dysentery depend on the paths and methods
    infection, the number of microbes in the body, level of immunity

    How dysentery is manifested

    The disease begins
    fast. At the beginning, the syndrome of general intoxication is developing,
    characterized by increasing body temperature, chills, feeling heat,
    breaking, decreased appetite, headache, decrease in arterial

    The defeat of the gastrointestinal tract is manifested by pain in
    stomach, first stupid, spilled throughout the belly having a permanent
    character. Then they become more sharp, grasp,
    Local in the lower parts of the abdomen, more often on the left. Pain usually
    amplified before the intestinal emptying.

    With a light course of illness, the fever is short-lived, from
    a few hours to 1-2 days, body temperature, usually,
    rises to 38°WITH. Patients worried moderate abdominal pains, in
    Basically before the act of emptying the intestines. Estiments have
    Cashitz-shaped or semi-liquid consistency, defecation frequency up to 10 times
    per day, mix of mucus and blood is not visible. Inxication and diarrhea
    persist within 1-3 days. Complete recovery occurs through
    2-3 weeks.

    Medium-heavy course of the disease - the beginning of the disease is fast.
    Temperature of the body with chills rises to 38 ~ 39°C and keeps on this
    level from a few hours to 2-4 days. Patients are bothering common
    weakness, headache, dizziness, lack of appetite. Intestinal
    disorders, as a rule, are joined in the next 2-3 hours from
    The beginning of the disease. Patients appear periodic gravity pain
    At the bottom of the abdomen, frequent false urges for defecation, feeling
    incomplete act of defecation. Stool frequency reaches 10-20 times in
    day. Megetive feces, often consist of one plumbings
    blood. Increased irritability, skin pallor. Language
    covered with thick white blooming, dryish. Inxication and diarrhea
    continue from 2 to 4-5 days. Full healing of the mucous membrane
    intestines and normalization of all the functions of the body occur no earlier than 1-1.5

    The difficult course of dysentery is characterized by very fast
    the development of the disease, sharply pronounced intoxication, deep
    Violations of the cardiovascular system. Disease
    It begins extremely fast. Body temperature with chills quickly rises
    up to 40°C and higher, patients complain of severe headache, sharp total
    Weakness, increased zray, especially in limbs, dizziness
    When you get up with bed, the absence of appetite. Often appear
    nausea, vomiting, IKOT. Patients bother abdominal pain,
    accompanied by frequent urges for defecation and urination. Chair
    more than 20 times a day, often the number of defecations is difficult to count («chair
    Without a bill»). The period of the sickness of the disease lasts 5-10 days.
    Recovery occurs slowly, up to 3-4 weeks, full normalization
    The intestinal mucosa occurs after 2 months and more.

    The diagnosis of chronic dysentery is established in case the disease lasts more than 3 months.

    Among the complications of the disease
    The most frequent are: infectious toxic shock,
    Infectious toxic damage to the nervous system, peritonitis,

    How to diagnose dysentery

    Diagnostics of dysentery
    Based on the results of the survey of the patient. Great
    Diagnostic value has a feast inspection at which you can
    Detect a mix of blood mucos. Laboratory confirmation
    Dysentery is carried out by bacteriological and serological methods.
    Bacteriological method (Schigell Sewing from Ferrence) at 3x
    The study ensures confirmation of the diagnosis in 40-60% of patients.
    Accelerated diagnosis of acute intestinal diarrheal infections can
    to detect antigens of pathogens and their toxins in
    biosubstrats - saliva, urine, feces, blood. To this end use
    Immunological methods with high sensitivity and
    Specificity: Immuno-enzyme analysis (ELISA), agglutination reaction
    latex (Ral), reactions of coaggglutination (RKA), immunofluorescence (reef),
    polymerase chain reaction (PCR).

    How to treatment with dysentery

    Treatment of patients
    Dysentery should be comprehensive and strictly individualized.
    Bed regime is needed, as a rule, only for patients with severe
    forms of illness. Patients with medigative forms are allowed to go out
    to the toilet. Patients with light shapes are prescribed to the chamber mode and therapeutic
    physical Culture.

    One of the most important terms in integrated intestinal therapy
    Patients are therapeutic nutrition. In the acute period with significant
    intestinal disorders prescribe table number 4; With improved state,
    decreasing intestinal dysfunction and appetite patients
    translated on table number 2, and in 2-3 days before discharge from the hospital - on
    Total table.

    Prescribe a patient an antibacterial drug is necessary with
    Accounting for information O «territorial landscape of drug sustainability»,
    T.E. Sensitivity to Him Shigell, allocated from patients in this
    locality recently. Combinations of two or more antibiotics
    (chemotherapy) are prescribed only in severe cases.

    The duration of the treatment of dysentery is determined
    improving the condition of the patient, normalization of body temperature,
    decrease in intestinal disorders. With a moderate form of dysentery
    The course of therapy may be limited to 3-4 days, with severe - 4-5 days.
    Low dysfunction in early recovery
    intestines (Kashitse-shaped chair up to 2-3 times a day, moderate phenomena
    meteorism) should not serve as a reason for continuing
    Antibacterial treatment.

    Dieseneria: diagnosis and treatment
    Patients with light dysentery in the midst of the disease,
    flowing with adhesion of mucus and blood in feces, are prescribed one of
    Next preparations: Nitrofurans (Furazolidon, Furadonin 0.1 g 4
    Once a day, Ersafuril (nifuroxazid) 0.2 g 4 times a day),
    Kotrimoxazole 2 tablets 2 times a day, oxychinolines (nitroxoline
    0.1 g 4 times a day, Intotrix 1-2 tablets 3 times a day).

    With a moderate course of dysentery, drugs are prescribed
    Fluoroquinolone groups: offloxacin 0.2 g 2 times a day or
    Ciprofloxacin of 0.25 g 2 times a day; Kotrimoxazole 2 tablets 2
    times a day; Intotrix 2 tablets 3 times a day.

    In severe dysentery, ophloxacin is prescribed 0.4 g
    2 times a day or ciprofloxacin of 0.5 g 2 times a day; Fluoroquinolones
    in combination with aminoglycosides; aminoglycosides in combination with

    In the dysentery of the flexner and the zone are prescribed polyvalent
    Dysenteric bacteriophage. The drug is produced in liquid form and in
    Acid Resistant Tablets. Take 1 hour before meals
    inside 30-40 ml 3 times a day or 2-3 tablets 3 times a day.

    With the easiest course of the disease compensation of liquid loss
    It is carried out at the expense of one of the finished compositions (citrothukosalan,
    Regidron, tour and other.). These solutions give low portions.
    The amount of drilled liquid should be 1.5 times higher than the loss of it with
    feces and urine.

    Patients with a moderate form of diarrhea recommended
    abundant drinking sweet tea or 5% glucose solution, or one of
    Ready solutions (citrothukosalan, recider, tour and other.) up to 2-4
    l / day.

    With severe intoxication, intravenous drip is shown
    Pouring a 10% solution of albumin, hemodesa and other crystalloid
    solutions (trisole, lactasol, azesol, chille), 5-10% glucose solution
    With insulin. In most cases, it is enough to introduce 1000-1500 ml
    one or two of the named solutions to achieve significant
    Improving the condition of the patient.

    For binding and removing toxin from the intestine, prescribe
    One of the enterosorbents - polyfepan on 1 tablespoon 3 times a day,
    Activated coal 15-20 g 3 times a day, enterodez 5 g 3 times
    per day, Polysorb MP 3 g 3 times a day, Smekt 1 bag 3 times in
    day or other.

    For neutralization of toxins, enzyme preparations are used: Pancreatins, Panzinors in combination with calcium preparations.

    In the acute period of diarrhea to eliminate the spasm of colon shown
    Application: hydrochloride doll (but-shp) 0.04 g 3 times a day,
    Papaverin hydrochloride 0.02 g 3 times a day. With significant
    Bowl syndrome is prescribed a but-sh (2 ml of 2% of the solution intramuscularly or
    1-2 ml of a 0.2% solution of platofillin hydrotathered subcutaneously.

    During the entire period of treatment, patients prescribe a complex of vitamins.

    In order to correct the biocenosis of the intestine, biosporin is prescribed, Bactorin,
    Bakutsubtil, FloniVin-BS 2 doses 2 times a day for 5-7 days.
    When choosing a drug, preference should be given to modern
    Complex drugs - Linex, Bifidumbacterin-Forte, Vitaflor, etc.
    Preparations are prescribed in standard dosage. With good tolerability
    In the period of recovery, fermented acidic and dietary
    bifi- and lact-containing products that have high healing

    Treatment of chronic dysentery patients (recurrent and
    Continuous) is carried out in infectious hospital.


    • Fluoroquinolones Ciprofloxacin 0.5 g 2 times a day or offloxacin 0.2 g 2 times a day for 7 days;
    • Immunotherapy, depending on the state of immunity - Timalin, Timogen, Levamizol, Dibazol, and DR.;
    • Panzinorm, Festal, Pankreatin, Pepsin and DR.;
    • elevated daose doses of vitamins;
    • treatment of concomitant diseases, gliscate and protozoan intestinal invasions;
    • For the restoration of intestinal biocenosis prescribed biospurn,
      Bactisporin, Linex, Bifidumbacterin-Forte, Vitaflor, Lacto Bacterin;
      These drugs are prescribed in a standard dosage for 2 weeks
      After etiotropic therapy simultaneously with pathogenetic means.

    The prediction in the treatment of patients with dysentery is usually favorable.

    Running acute dysentery are discharged from the hospital not earlier,
    than 3 days after clinical recovery (normalization
    body temperature, chair, disappearance of signs of intoxication, pain in
    abdomen, spasm and intestinal pain), in the absence
    Pathological changes in laboratory studies.
    Chemoprophylaxis in contact with patients with patients is not held.

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