Bacillary Dysentery
Dirty, green, fibrous sloughing areas or
(Shigellosis)
Bacillary dysentery is an acute bacterial infection of
the intestines characterized by diarrhea and fever
and is associated with the passing out of bloody-
mucoid stools accompanied by tenesmus.
Tenesmus – cramping rectal pain. It is the sensation
of inability or difficulty to empty the bowel at
defecation, even if the bowel contents have already
been evacuated.
Etiologic Agent:
Shigella Dysenteriae: the most severe
Shigella Flexneri: the epidemic group and
easily turn to chronic
Shigella Boydii: tropical and suborn
Shigella Sonnei: the most mild
Incubation period:
– The incubation period is 7 hours to seven
days, with an average of three to five days.
Period of communicability:
– The patient is capable of transmitting the
microorganism during the acute infection
until the feces negative of the organism.
Some patients remain carriers for a year or
two
Mode of transmission:
The organism is transmitted through
ingestion of contaminated food or water or
milk.
It is transmitted by flies or through other
objects contaminated by the feces of the
patient.
Fecal-oral transmission is possible.
Pathology:
A. After the incubation period, the organism
invades the intestinal mucosa and causes
inflammation.
B.
ulcers are formed.
C. Within a few days, the stool may contain
pus, mucus, and blood.
Clinical Manifestation:
– Fever, especially in children
– Tenesmus, nausea, vomiting, and headache
– Colicky or cramping abdominal pain
associated w/ anorexia and body weakness
– Diarrhea w/ bloody-mucoid stools that bare
watery at first
– Rapid dehydration and loss of weight.
Complications:
 Rectal prolapse, particularly in
undernourished children.
 Respiratory complications, such as cough
and pneumonia.
 Non-suppurative arthritis (infectious
arthritis; caused by bacterial infection in the
joint) and peripheral neuropathy.
Diagnostic Procedures:
1. Fecalysis or microscopic examination of
stools.
2. Isolation of the causative organism fr4om
rectal swab or culture.
3. Peripheral blood examination
4. Blood culture
5. Sheets if polymorphoneuclear leukocytes
seen in staining w/ methylene blue.
Modalities of treatment:
Antibiotics are of question in the treatment
of shigellosis; however, ampicillin,
tetracycline, and Cotrimoxazole may be
useful in severe cases.
IV might be infused with normal saline (with
electrolytes) to prevent dehydration
Low-residue diet is recommended.
Anti-diarrheal drugs are contraindicated
because they delay fecal excretion that can
lead to prolonged fever.
 Nursing Management:

 Maintain fluid and electrolyte balance

to prevent profound dehydration.
 Keep the patient warm and
comfortable.
 Restrict food until nausea and vomiting
subsides.
 Isolation can be carried out through
medical aseptic technique.
 Personal hygiene must be maintained.
 Excreta must be properly disposed.
 Concurrent and terminal disinfection
should be employed.
 Return to normal activities must be
gradual because relapse may occur as a
result of fatigue.

Common Nursing Diagnosis:

Pain and discomfort
Fear
Alteration in bowel elimination
Altered nutrition: Less than body
requirement
Anxiety
Altered body temperature
High risk for infection
PREVENTION:
A. Sanitary disposal of human feces
B. Sanitary supervision of processing,
preparation, and serving of food, particularly
those eaten raw.
C. Adequate provision of safe washing
facilities.
D. Fly control and protection against fly
contamination.
E. Isolation of patient during acute stage.
F. Protection and purification of public water
supply.
G. Persons known to be infected should be
excluded from handling food for public
consumption.