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Overview of bacillary dysentery bacillary dysentery (referred to as bacillary dysentery) is caused by the Shigella common intestinal diseases. Clinically, fever, abdominal pain, diarrhea, tenesmus and mucus in a sense it is characterized by pus and blood. The basic pathological lesion of the colonic mucosa of congestion, edema, hemorrhage and other exudative inflammation. Into the cause of bacillary dysentery topic (a) of the source of infection source of infection, including patients and carriers. Patients with acute non-acute and chronic dysentery hidden evil thought typical of bacillary dysentery is an important source of infection. (B) the transmission of Shigella patients or carriers with the feces, through contaminated hands, food, water or living contact, or flies, cockroaches and other indirect communication, ultimately the digestive tract through the mouth so that by the tender susceptible . (C) of the population susceptibility of Shigella generally susceptible population, pre-school children more ill, and poor health habits, adult patients with lower body resistance and contact opportunities on the infection, combined with bacillary dysentery patients without consolidation of post-immunization power between different bacteria and between different serotypes of Shigella, no cross-immunity, it is caused by repeated infection or repeated re-infection and disease. Symptoms incubation period is generally 1 to 3 days (a few hours to 7 days). (A) can be divided into three types of acute dysentery. 1. Acute typical acute onset, chills, fever, more than for the 38 ~ 39 ℃, with dizziness, headache, nausea and other symptoms of systemic poisoning and abdominal pain, diarrhea, stool was mud began to thin paste or water samples, up to, following the it was mucus or mucus pus and blood, are small, ten times a day to dozens of defecation ranges with tenesmus. Left lower quadrant tenderness, which may provide the intestines spasm hit cable. Course of about a week or so. Small number of patients vomiting can be severe, rehydration is not timely dehydration, acidosis, electrolyte imbalance, a secondary shock. 2. Acute atypical type is generally not heat or fever, mild abdominal pain, diarrhea, the number of small, 3 to 5 times more mucus, pus and blood will generally not the naked eye, without tenesmus. Course is generally 4 to 5 days. 3. This type of acute poisoning type more common in children 2 to 7 years strong, rapid onset, rapid progress in a critical condition and high mortality. (B) delayed healing of chronic dysentery disease more than 2 months or more is called chronic dysentery, and acute treatment is not more timely or not completely, decreased resistance to bacterial resistance or the body concerned, and is often due to improper diet, cold , induced by overwork or mental factors. Check 1. The total number of peripheral blood leukocytes in acute dysentery and neutrophil number increased, toxic bacillary dysentery reach 15 ~ 30 × 109 / l or more, sometimes a left shift can be seen. Often as the mild anemia of chronic dysentery. 2. Stool (1) examination: see more white blood cells, or piles of pus cell, a small amount of red blood cells and macrophages. Will be full of bloody vision of erythrocyte. (2) Training: detect dysentery bacteria to do rash. Should be taken early, fresh, not mixed with urine, faeces containing blood and pus or intestinal viscosity test, multiple submission, can increase the positive rate. 3. Comparison of rapid pathogenic examination is simple, fast, sensitive also good for early diagnosis. Treatment (a) the treatment of acute dysentery 1. General treatment of bed rest, the digestive tract isolation. Give digestible, high-calorie, high vitamin diet. For high fever, abdominal pain, dehydration were given fever, Zhijing, oral saline rice soup or give oral rehydration salts (ors), vomiting required intravenous rehydration, daily 1500ml ~ 3000m. 2. Pathogen treatment increased the resistant strains, the best application of ≥ 2 antimicrobial drugs. (B) the treatment of toxic dysentery 1. Sensitive to anti-infective select antimicrobial agents, combination therapy, intravenous administration, patients are feeling better to be changed after the oral administration. 2. Control fever and convulsions 3. The treatment of circulatory failure: Basic with septic shock treatment. Are: ① the effective blood volume expansion; ② correct acidosis; ③ cardiac treatment; ④ relieve spasm; ⑤ maintain acid-base balance; ⑥ glucocorticoids. 4. Prevention of cerebral edema and respiratory failure (c) the treatment of chronic dysentery 1. Find incentives symptomatic disposal. Avoid over exertion, without rendering the abdomen cold, Wu Shi raw diet. Vulnerable people should use the immune enhancer. When the intestinal flora imbalance, avoid the abuse of antibiotics stop resistance to antimicrobial drug use. Lactic acid bacteria use enzymes health or to facilitate the growth of intestinal anaerobic bacteria. 2. For a more prolonged intestinal mucosal lesions are also using retention enema therapy. Schistosomiasis Schistosomiasis is an overview of the adult schistosome parasites in the body caused by endemic disease, mainly popular in Asia, Africa, Latin America's 73 countries, about 2 million or so the number of patients. Cause (a) source of infection: the feces of patients with Schistosoma japonicum eggs containing living, disease-oriented primary source of infection. (B) transmission: mainly through the skin, mucous membrane exposure to infected with contaminated water. (C) susceptibility: human and vertebrates are generally susceptible to the schistosome. Symptoms (a) the invasion period: Patients may have cough, chest pain, occasionally blood stained sputum and so on. (B) of the acute phase: clinical practice often the following characteristics: 1. Fever: The main symptoms of the current, low fever, duration and severity of hot type varies depending on the infection. 2. Gastrointestinal symptoms: diarrhea-like stool often has, to blood and mucus. 3. Hepatosplenomegaly. 4. Pulmonary symptoms: cough quite common, may have chest pain, bloody sputum and other symptoms. (C) of the chronic stage: more a result of the acute phase has not been found, no treatment or inadequate treatment, or repeated infections cause few times, and gradually develop into chronic. Current general sustainable 10 to 20 years, because of its long duration, symptom severity can be very different. (D) late: the patient extreme weight loss, ascites, splenomegaly, abdominal venous engorgement and other serious symptoms later. Check stool hatching test Shen precipitation method is the main hatch diagnosis. Colonoscopy and intestinal biopsy: rather suspected Schistosoma eggs repeatedly negative stool examination for colonoscopy. Blood: acute leukocytes and eosinophils was significantly increased. Treatment (a) support and symptomatic therapy. (B) of the pathogenic therapy. Praziquantel for the pyrazine morpholine compound, colorless, odorless crystalline powder. Slightly soluble in ethanol, insoluble in water. Larvae, and adult children have role in the killing insects. Is the ideal anti-schistosome drugs. Amoebic dysentery (intestinal amebiasis) outlined amoebic dysentery, also known as intestinal amebiasis, is organized by the pathogenic amoeba dissolved after the invasion of the colon wall caused by dysentery symptoms in the digestive Road infectious diseases. The disease throughout the world, more common in tropical and subtropical regions. More common in northern China. Incidence in rural than urban; men than in women, adults than children, mostly distributed in the cause of chronic patients, convalescent patients and carriers of cysts is the major source of infection of this disease. Through contaminated water, vegetables, fruits and other gastrointestinal spread of food, but also through contaminated hands, supplies, flies, cockroaches and other indirectly through oral transmission. Ordinary people susceptible to infection does not produce immunity, it is easy to re-infection. Symptoms average incubation period of 1 to 2 weeks (4 to a few months), there are different types of clinical manifestations. (A) asymptomatic (cyst carrier): This type of clinical symptoms often do not, a number of amoeba cysts were found by stool examination. (B) of the general type: onset and more slowly, light symptoms of systemic poisoning, often without fever, mild abdominal pain, diarrhea, multiple times a day will be around in 10, medium, blood and mucus, blood was mixed with necrotic tissue jam-like, with the stench of corruption, including dysentery, amebic trophozoites with a large number of red blood cell stacks, one of its features. (C) light: those found in strong constitution, the symptoms slightly. (D) of fulminant: rare. (E) chronic type: often due to improper treatment of the acute phase alternating diarrhea and constipation, so that the clinical symptoms of recurrent, persistent or years more than in February unhealed. Often due to cold, fatigue, diet, etc. accidentally attack. Check 1. Clinical manifestations: slow onset, mild symptoms, diarrhea, number of small, dark red sauce Secheng like feces. 2. Stool examination: amoeba under a microscope for the detection of soluble tissue an important basis for diagnosis. 3. Sigmoidoscopy. 4. x-ray barium enema examination: intestinal stenosis, amebic tumor of a certain value. 5. Serology: amoebae pure antigen is available specific antibodies, when the body has the time of the formation of invasive disease antibodies, antibody test negative cyst carriers. Commonly used indirect hemagglutination, elisa, indirect fluorescent antibody, counter immuno electrophoresis, agar diffusion precipitation test and so on. Treatment (a) General treatment: the acute phase should be bed rest, isolation from intestinal symptoms, finding out 3 consecutive stool trophozoites and cysts, nutrition, fluids or blood transfusions when necessary. (B) Pathogen treatment: 1. Metronidazole (Flagyl). 2. Metronidazole sulfonyl imidazole. 3. Chlorine powder sugar esters (phenyl chloramines). 4. Antibiotics. 5. Chinese medicine: Brucea (Sophora sub) Yan, Pulsatilla, garlic can be used.

Amoebic and bacillary dysentery and other bowel disease is often prone to confusion in diagnosis, resulting in misdiagnosis. So, to master the basic clinical differential diagnosis, especially with the identification of bacillary dysentery, for the great significance for the primary care doctors. The identification of amoebic dysentery amoebic dysentery and bacillary dysentery are sporadic, systemic symptoms are mild, low heat, toxemia rare; dysentery was epidemic, severe systemic symptoms, as fever, and the higher toxemia obvious. Abdominal pain, diarrhea, amoebic dysentery in the light, diarrhea several times or ten times a day; and severe abdominal pain and diarrhea bacillary dysentery, diarrhea than a dozen times or dozens of times a day, with significant tenesmus. The former is mostly right lower quadrant abdominal tenderness; the latter are mostly left lower abdomen. The former manure medium, accompanied by blood and mucus, dark red or jam-like, there are rotten stench; which less or no fecal, as pus, mucus mixed with blood, bright red or pink jelly-like, non- fecal odor. The former stool examination a few broken white blood cells, clusters of old red blood cells; the latter is a large number of piles of pus, distributed the majority of fresh red blood cells, macrophages common. Amebic dysentery amebic stool culture can be positive; bacillary dysentery dysentery bacteria-positive rate of 50% or more. The former can be complicated by liver and lung abscess; which occasionally arthritis, peripheral neuritis, and conjunctivitis. Chronic amoebic dysentery and chronic bacillary dysentery and sometimes difficult clinical distinction, it is sometimes necessary to colonoscopy and hospital conditions pathogenic examination. At the same time, clinical disease associated with should be noted that the possibility of the two. Schistosomiasis Schistosomiasis of acute and chronic dysentery-like symptoms may have. The main characteristics of the disease: there is water in the history of exposure to endemic areas; common hepatosplenomegaly; blood eosinophilia; schistosome eggs in feces can be found, or found miracidium hatching; intestinal biopsy pressed to find eggs ; serum cercariae egg membrane ring precipitation test or test positive. Colonic pouch pouch colon disease ciliate ciliate ciliate disease parasite is due colonic pouch in the colon and ileum (mainly the cecum and sigmoid colon) caused similar amebic colitis. Clinical manifestations were more than a sudden, acute type of upper abdominal discomfort, nausea and abdominal pain, mucus pus and blood will be a day 3 - 15 times, accompanied by tenesmus, and might dehydration, malnutrition and weight loss. In chronic seizures may have long-term cycle of diarrhea, loose stools onset atherosclerosis when, accompanied by mucus, usually without pus and blood, there is a temporary diffuse abdominal pain, or in the Ministry of ileocecal and sigmoid tenderness. Patients usually caused by a cold, eating disorders, alcohol and fatty food causes periodic diarrhea. Some patients can cause appendicitis and intestinal perforation. Stool smear microscopy that the colon pouch ciliates trophozoites or cysts, can be confirmed. Ramsey giardiasis giardiasis Ramsey Ramsey, Department of Giardia lamblia in patients with chronic abdominal pain caused by intestinal parasites, diarrhea, and can be accompanied by insomnia, headache, sweating, anemia, anorexia and other symptoms. Some may be parasitic biliary system, caused by cholecystitis, cholangitis. Patients do trophozoites and cysts found in stool examination can be confirmed. Associated with biliary symptoms, can be found in the duodenal drainage fluid trophozoites. Chronic non-specific ulcerative colitis chronic non-specific clinical manifestations of ulcerative colitis and chronic amoebic dysentery difficult to distinguish. To the conditions required hospital colonoscopy. The colonoscopy findings characterized by: intestinal congestion, touch and easy bleeding, major bleeding visible tip, small superficial ulcers, complex with mucopurulent discharge. In addition, the patients stage of disease longer, the intestinal wall due to fibrosis and hardening, thickening, so bags X-ray examination shows disappearance of the colon, intestinal samples were lead pipes. Ulcerative intestinal tuberculosis is characterized by ulcerative intestinal tuberculosis: more common in patients with pulmonary tuberculosis, especially cavitary tuberculosis; have consumed hot, night sweats, weight loss, malnutrition, tuberculosis, loss of appetite and other symptoms such as chest pain, cough, hemoptysis, etc.; stool mostly yellow thin, gruel-like, with mucus and pus and blood rare, microscopic examination only see a small amount of red, white blood cells. Colon cancer, such as necrosis as ulcers, dysentery-like pus and blood will be there. Ulcers secondary bacterial infection, there colitis symptoms. Lesions such as in the rectum, may be associated with tenesmus. Clinical manifestations very similar to amoebic dysentery, digital rectal examination should be made, and to the hospital for a colonoscopy and a conditional barium enema X-ray examination. Doctors in clinical, should always be wary of colon cancer, and pay attention to the possibility of coexistence with amoebic dysentery.
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Bacillary dysentery and amoebic dysentery on a single herb treatment - "Traditional Chinese Medicine" in 1955, 08 of the literature sources CNKI www.cnki.net
Diarrhea in the clinical characteristics of the performance: (1) have small amounts of diarrhea and frequency, (2) contains pus and blood and mucus, (3), abdominal pain and there is tenesmus. The pathology of colitis and ulcer characteristics. Dysentery divided into two major types: one for bacillary dysentery, caused by the Department of a special bacteria; one for amoebic dysentery, caused by the amoeba system, it is briefly described as follows, respectively: a, bacillary dysentery pathogens: Shigella bacteria are five races that Shigella, Flake's, Bolt's, Arizona's, Brahimi's five times. In addition to Shiga toxin produced neurotropic outside the organization, in general, only the intestine of endotoxin prepared addicted. Notes
】 【DOI: cnki: ISSN :1001-1668 .0.1955-08-007
Snapshot】 【text:
Chen dysentery performance characteristics of the micro-bed articles: (1) the amount of abdominal side is very few but they cover, (2) contains blood and mucus instantaneous, (3), abdominal pain and urgent assistance has wrapped down. The pathology of Termeer Yan Yu Yan Tai gave each collapse. Xiang divided into two major types of dysentery: a bacterial dysentery defend Yan, Paul released a special kind of defense equipment caused by bacteria, an amoebic dysentery, amoebic original chu caused by Paul, it is the medium, respectively, for the tendons to move as follows: First, to defend the original leg of bacillary dysentery diseases: dysentery bacteria to defend
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