dysentery

(dis′ĕn-ter″ē)

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[dys- + enteron]
Diarrhea containing blood and mucus, resulting from inflammation of the walls of the gastrointestinal tract, esp. the colon.

CAUSES
Dysentery is caused by bacterial, parasitic, protozoan, or viral, infections and is most common in locations or situations with inadequate sanitation, where food and water become contaminated with enteric pathogens.

SYMPTOMS AND SIGNS
Painful abdominal cramps, rectal urgency, malaise, and fever are usually present. Severely affected patients (esp. infants and older adults) may become weak, dizzy, dehydrated, and hypotensive.

DIAGNOSIS
Dysentery is diagnosed by its clinical signs and symptoms. Laboratory examination of the stool (microscopic and microbiologic) is confirmatory and used to guide antibiotic therapy when needed.

PREVENTION
Prevention of infection is the major emphasis of health care providers by improving the handling of waste products in the community (part of a public health program and a public works project) and by teaching proper techniques for handling, cooking, and storing food.

TREATMENT
Infants, older adults, people deprived of rehydration, or the chronically ill may become severely dehydrated, develop metabolic acidosis, and require intravenous or oral rehydration and, on occasion, antibiotic therapy.

PATIENT CARE
Travelers to the tropics (among other locations) are especially prone to dysentery. They should make certain the food and water they consume is sterilized, boiled, or thoroughly cooked. Handwashing after contact with potentially infectious materials reduces fecal-oral transmission of enteric pathogens.

To monitor the effectiveness of rehydration of the patient, health care providers should make accurate measurements of volumes of fluid consumed and infused and patient output (I & O). Weight should be measured daily.

SEE: diarrhea; SEE: Escherichia coli; SEE: Shigella

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