2. CHARACTER
 Enterobacteriacae
 Gram – negative bacilli
 Non – motile
 Non – lactose fermenter
 H2s – negative
 Capsule (k-antigen)
 O – somatic antigen

3. SPECIES
 Shigella. dysenteriae . 10 – serotype
 Sh. flexenri . 6 – serotype
 Sh. boydii . 15 - serotype
 Sh . sonnei . 1 - serotype

4. BACILLARY DYSENTERY
 Acute Bacterial Infection Of
The Intestine (Colon )
 Caused By All Species
 Major Cause Of Diarrheal
Disease And Mortality In
 Developing Countries
 – (Poor Hygiene , Nutrition)
 – (Contaminated Food & Water)

5. EPIDEMIOLOGY
 Human
 Fecal – oral route
 ( Water ,, food ,, feces ,, flies )
 Person – person contact
 Childhood
 Infectious dose :: 10 - 100 organisms
 High infectivity
 Source - cases , carriers
 Daycare centers,,.
 Travel ,

6. CLINICAL PICTURE
 Fever
 Bloody diarrhea
 Abdominal cramps
 Mucus , pus
 Mild infection :watery stool
 Bacteremia – rare
 Hemolytic – uremic syndrome

7. PATHOGENESIS
 Enteroinvasive
 – Colonic mucosa
 – Tissue damage ulcers
 Exotoxin (shiga toxin ) – Shigella. dysenteriae
 – Enterotoxin (absorption)
 – Cytotoxin ( a – 5 b)
 – Neurotoxin (nerve damage)

8. LABORATORY DIAGNOSIS
 Culture Stool
 Rectal Swbs
 Macconkey Agar
 Xld Agar
 Selenite F Broth
 Shigella Salmonella Agar
 Microscopy :: Leucocytes ,, Rbc
 Biochemical :: Tsi - No Gas,, H2s ,,
Acid
 Non Motile
 Serology Test :: Slide

9. LABORATORY DIAGNOSIS
 Specimen
 Stool
 Vomitus
 Food
 Microscopy -wbc.. Rbc.. Mucus
 ( Gram stain :-gram negative rods )
 Culture
 Identification

10. TREATMENT
 - Water electrolytes
 - No antibiotics
 -Severe infection
 - Then use of antibiotics.

11. PREVENTION
 SUPPLY OF PURE WATER
 PERSONAL HYGIENE ( HANDS)
 SEWAGE DISPOSAL
 FOOD HYGIENE
 INSECT CONTROL (FLIES)
 VACCINE (ORAL) - 6 MONTHS

12. PREVENTIION
 Proper food handling
 Personal hygiene
 Refrigeratiion
 Proper canning
 Public education

13. THANK
YOU