Dysentery is an inflammation of the large intestine characterized by frequent stools containing blood and mucus, abdominal pain, and tenesmus. It can be caused by bacteria (like Shigella), protozoa (Entamoeba coli and Balantidium coli), or helminths (Schistosoma). Shigella dysenteriae causes the most severe form of bacterial dysentery. The disease spreads through the fecal-oral route or contaminated food and water. Symptoms include fever, abdominal pain, and bloody stools. Complications can include dehydration, toxic megacolon, and hemolytic-uremic syndrome. Prevention relies on good sanitation, safe food and water

1. Dysentery

2. Definition:
•Clincal syndrome arising from
inflammation of large
intestine(colon) characterized by
frequent stools with (blood and
mucus),tenesmus and abdominal
pain.

4. Classification (according to
causative agents)
•Bacterial (Shigellae)
•Protozoal ( Entamoeba coli and
Balantidium coli)
•Helminthic (Schistosoma)

5. Shegellosis
• 4 groups of Shigella Bacilli , resistant outside the body but destroyed
by heat and disinfectants
• They exit in feces
• Group A : shigella dysenteriae including Shiga bacillus (severe disease
by infection and exotoxin)
• Group B : Shigella flexneri
• Group C : Shigella boydii
• Group D : Shigella sonnei (mild disease)

7. Mode of infection :
Direct: hand to mouth infection.
Indirect : by a common vehicle ( contaminated water, milk or
food)
Incubation period: less than 4 days usually
Period of Communicability : during the acute infection , up to 4
weeks after illness without treatment, 2-3 days with
appropriate treatment or maybe Asymptomatic carriers.

9. Clinical Picture:
Mild ( could be unnoticed)
Acute cases: characteristic symptoms: sudden
onset,fever,prostration,tenesmus, squeezing pain of lower
abdomen and watery stool with fresh blood and mucus (self
limited in few days)
Severe fluminant disease : shiga infection due to toxemia.
Complications:
only in shiga ( dehydration , toxic megacolon and hemolytic-
uremic syndrome maybe fatal.

10. Prevention :
A- Environmental Sanitation :
1-sanitary sewage disposal.
2-safe water supply.
3-food sanitation
B- Health education ( 5 keys of WHO to prevent food borne diseases)
1- Keep clean!!!!
2- separate raw and cooked food.
3-Cook thoroughly and reheat cooked food (boiling of milk)
4-Keep food at safe temperature (refrigeration)
5- Safe water and raw materials (covered from flies)

12. Control:
1- Case: finding, isolation at home , disinfection and treatment
2- Contacts: House hold contacts are excluded from work especially if they're
food handlers or workers in nurseries and schools.
3-Stool cultures to detect carriers and mild cases to be given anti microbial until
they become culture negative.
4-Epidemic measures : investigation of outbreak to detect source of infection (
collecting food remnants for laboratory isolation of oragnism.

13. Diagnosis: Clinically and laboratory by culture of
feces and serological testing.
Treatment : Antimicrobial drugs ( Ciprofloxacin or
Ofloxacin.
Rehydration and rest.

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