Dysentery

DysenteryDYSENTERY (bacterial dysentery, shigellosis) is an infectious disease with fecal-oral mechanism of transmission, caused by bacteria of the genus Shigella. Flow primary lesion of the mucosa of the distal colon. Etiology, pathogenesis. Pathogens are 4 species of Shigella: 1). Shigella dysentery; 2). Shigella the Flexner (subspecies Newcastle); 3). Shigella Boyd; 4). Shigella sonnei. The most common are Shigella sonnei and Flexner. Pathogens can long persist in the environment (up to 1.5 months). Some food products they are not only preserved, but it may breed (dairy products, and others). Increasing resistance of Shigella to various antibiotics and sulfonamides resistente most strains. Received avirulent strains of Shigella, which are used for the development of live attenuated vaccines for enteric immunization. The infectious dose for dysentery small. Proved the possibility of parasitism of Shigella in the epithelium of the intestine. The disease occurs when the penetration of the blood of toxins of Shigella. Dysenteric toxins act on the vascular wall, the Central nervous system, peripheral nervous ganglia, the sympathetic-adrenal system, the liver, the organs of circulation. In severe forms of dysentery patients usually die from infectious-toxic shock. The symptoms for. The incubation period is from 1 to 7 days (usually 2-3 days). Clinical manifestations of dysentery can be divided into the following forms. I. Acute dysentery: a). typical (of varying severity); b). atypical (gastroenterocolitis); in). subclinical. II. Chronic dysentery: a). recurrent; b). continuous (protracted). III. Postdizenteriyny bowel dysfunction (postdizenteriyny colitis). Typical forms of dysentery begin acutely manifested symptoms of intoxication (fever, poor appetite, headache, weakness, drop in blood pressure and signs of lesions of the gastrointestinal tract. Abdominal pain initially dull, diffuse around the abdomen, constant, then it becomes more .sharp, cramping, localized in the lower abdomen, usually on the left or above the pubic area. Pain increases before defecation. Also appear telosma - drawing pain in the rectal area, radiating to the sacrum. They occur during defecation and continue within 5-15 min after it. Enemy due to inflammatory changes of the mucosa ampullar rectum. With the defeat of the distal large intestine associated false desires and prolonged defecation, feeling his incompleteness. Palpation of the abdomen is marked spasm and tenderness of the large intestine, more pronounced in the area of the sigmoid colon. Chair ucase (up to. 10 times a day or more). The first defecation fecal, then they have an admixture of mucus and blood, and in more severe cases when urinating allocated only a small amount of bloody mucus. In milder forms (up to 80% of all diseases), patients feel satisfactory, the body temperature is low or normal, abdominal pain minor, tenesmus and false desires may be missing. Chair 3 - 5 times a day, it is not always possible to detect admixture of mucus and blood in stool. Subclinical forms of dysentery usually are diagnosed by bacteriological examination, clinical symptoms are weak. Such patients often consider themselves to be healthy and no complaints at present. When atypical forms on the background of the above symptoms are observed phenomenon of acute gastritis (epigastric pain, nausea, vomiting), making it difficult to diagnose. A severe form of dysentery occurs in 3-5% of cases. It occurs with high fever, or, conversely, with hypothermia.


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