Dysentery: Symptoms, Causes, Diagnosis, and Treatment

Dysentery is an intestinal infection causing bloody, mucoid diarrhea with abdominal cramps. It is a significant global health burden, especially in children.

Symptoms

• Frequent loose stools with blood and mucus
• Abdominal cramps (often lower abdomen)
• Fever (may be high)
• Nausea, vomiting
• Tenesmus (urgency with little output)
• Dehydration signs: dry mouth, decreased urine, dizziness, fatigue
• Weight loss (if prolonged)

Causes

• Shigella (shigellosis) – most common bacterial cause; highly contagious.
• Entamoeba histolytica (amoebic dysentery) – parasite; can cause liver abscess.
• Salmonella, Campylobacter, E. coli (EHEC/STEC)
• Viral: Rare; norovirus causes watery diarrhea, not classic dysentery.

Transmission

Fecal-oral route: contaminated food/water, person-to-person (poor hygiene), flies.

Diagnosis

• Stool culture, PCR, O&P (ova and parasites)
• WBCs on stool smear (inflammatory diarrhea)

Treatment

• Oral rehydration (ORS) – critical.
• Antibiotics for bacterial dysentery: Ciprofloxacin, azithromycin, ceftriaxone (guided by local resistance).
• Antiparasitic for amoebiasis: Metronidazole/tinidazole + luminal agent (paromomycin).
• Avoid antimotility agents (loperamide) in bloody diarrhea.

Prevention

• Safe water, sanitation, hygiene (WASH)
• Handwashing with soap
• Food safety (cook thoroughly, peel fruits)
• Vaccines in development (Shigella, ETEC)