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Associate Editor(s)-in-Chief: Mydah Sajid, MD[1]

Dysentery in adults resident survival guide

Overview

Causes

Life-threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

  • Does not include any known cause

Common Causes

Evaluation

References

 
 
 
Characterize the symptoms:
  • Duration of diarrhea
  • Frequency and consistency of stools
  • Presence of mucus and blood in the stools
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
To evaluate cause ask the following questions:
  • Food history
  • Occupational exposure (e.g. daycare center, poultry farm)
  • Exposure to animals (pets, poultry, zoo, turtles)
  • Recent travel to endemic areas
  • Medication history (use of proton pump inhibitors increase susceptibility to infection with Shigella)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does the patient have any of the following clinical signs or history?
  • Old age (more than 70 years)
  • Presence of co-morbidities (advance cardiac disease, severe immunocompromised state)
  • Fever (>101.3 degrees Fahrenheit)
  • Presence of severe symptoms
  • Need for hospitalization
  • Signs of dehydration (dry mucous membranes, sunken eyes, decreased skin turgor, orthostatic hypotension, oliguria, dark-colored urine, and drowsiness)
abdominal tenderness on palpation, rebound tenderness, abdominal distention, and abdominal rigidity.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Perform the following stool tests:
  • Bacterial culture for Salmonella, Shigella, and Campylobacter.
  • Test for Shigella toxin and E. coli O157: H7
  • Test for fecal leukocytes and lactoferrin.
 
 
 
 
 
Does the patient have any of the following:
  • Clinical signs suggestive of inflammatory bowel disease
  • Symptoms present for more than a week despite conservative management
  • The patient is a health care worker or food handler (which can be a potential health hazard)
  •  
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
    Is the fecal leukocytes or lactoferrin test positive?
     
     
     
     
    Yes
     
    No
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
    Yes
     
    No
     
    * Perform routine stool culture.
    • Specific tests should be performed depending upon the patient’s history.
     
    No need to perform Stool culture and additional tests.