CHARACTER

Enterobacteriacae

Gram – negative bacilli

Non – motile

Non – lactose fermenter

H2s – negative

Capsule (k-antigen)

O – somatic antigen

SPECIES

Shigella. dysenteriae . 10 – serotype

Sh. flexenri . 6 – serotype

Sh. boydii . 15 - serotype

Sh . sonnei . 1 - serotype

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)

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 ,

CLINICAL PICTURE

Fever

Bloody diarrhea

Abdominal cramps

Mucus , pus

Mild infection :watery stool

Bacteremia – rare

Hemolytic – uremic syndrome

PATHOGENESIS

Enteroinvasive

– Colonic mucosa

– Tissue damage ulcers

Exotoxin (shiga toxin ) – Shigella. dysenteriae

– Enterotoxin (absorption)

– Cytotoxin ( a – 5 b)

– Neurotoxin (nerve damage)

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

LABORATORY DIAGNOSIS

Specimen

Stool

Vomitus

Food

Microscopy -wbc.. Rbc.. Mucus

( Gram stain :-gram negative rods )

Culture

Identification

TREATMENT

- Water electrolytes

- No antibiotics

-Severe infection

- Then use of antibiotics.

PREVENTION

SUPPLY OF PURE WATER

PERSONAL HYGIENE ( HANDS)

SEWAGE DISPOSAL

FOOD HYGIENE

INSECT CONTROL (FLIES)

VACCINE (ORAL) - 6 MONTHS

PREVENTIION

Proper food handling

Personal hygiene

Refrigeratiion

Proper canning

Public education

THANK YOU