Bacterial dysentery is a highly contagious, severe diarrheal disease caused by various bacteria of the genus Shigella. In Germany mainly travelers. Travelers affected. The disease often occurs in children under five years of age and is notifiable.
Occurrence
Bacterial dysentery is common worldwide. The disease occurs most frequently in warm countries with poor hygienic conditions and a lack of sewage supply. In developing countries about one million people fall ill every year. Children are especially often affected. According to the Robert Koch Institute, the cases of shigellosis occurring in Germany in recent years have been imported mainly from Egypt, India, Morocco, Tunisia and Turkey.
Infection
Infection occurs from person to person via skin contact (z.B. Handshake). Even the smallest amounts of the bacterium are sufficient for infection. Infection by bacteria-contaminated drinking water, bathing water, food or flies is also possible. Sick persons are contagious as long as shigella can be detected in the stool ? so about one to four weeks.
Course
Depending on the type of pathogen, the course of the disease varies. As a rule, watery diarrhea suddenly develops one to four days after infection. Fever, loss of appetite and abdominal cramps may also occur. In the harmless variant of dysentery, the symptoms disappear after a week.
If the bacterium Shigellosa dysenteria is the cause of the disease, which produces the toxin Shiga toxin, the dysentery is more severe. Bloody, mucous diarrhea develops, accompanied by colicky intestinal pain. The severe fluid-. Loss of electrolytes can lead to collapse. Formation of ulcers in the large intestine, dilatation of the intestine and even intestinal rupture are also possible.
The infection is especially dangerous for children and immunocompromised people. Severe complications such as hemolytic uremic syndrome (HUS) with kidney failure. Decomposition of red blood cells are rare. These complications are most frequently found in infections with the pathogen S.flexneri, which can also cause joint inflammation.
Diagnosis
It is important for the physician to be informed about recent stays abroad, because bacterial dysentery occurs almost exclusively in developing countries.
If shigellosis is suspected, the diagnosis is made on the basis of a stool sample. Under the microscope, the doctor examines whether there is an elevated number of white blood cells in the stool. Shigella can also be detected directly in the laboratory ? However, the pathogens are very sensitive, so that the sample must be transported quickly to the laboratory in a special container. The laboratory can also determine if the type of Shigella bacterium detected has already developed resistance to a specific antibiotic.
Treatment/Therapy
An infection with bacterial dysentery is treated with antibiotics. This not only speeds up the healing process, it also reduces the risk of infection. Antibiotics from the quinolone group, trimethoprim-sulfamethoxazole, azithromycin, tetracycline, doxycycline and ampicillin have proven to be effective.
It is also important that patients drink plenty of fluids to compensate for fluid loss. The lost salts can be replaced by electrolyte solutions from the pharmacy. Medications that stop diarrhea are not recommended.
Precaution
Regular hand washing is the best precaution against bacterial dysentery. fill in a questionnaire about your trip. Health situation from. Within the next three working days, you will receive a comprehensive medical check-up from a doctor experienced in travel medicine written advice on recommended vaccinations and precautions for your destination country as well as on the malaria, yellow fever and dengue fever situation on site. Example>> Your travel dossier
Travel advice by telephone
Make an appointment for a medical consultation for the Answering your travel medicine questions as well as for current Vaccination recommendations for your destination. A doctor experienced in travel medicine will call you back at the telephone number you have given at the time of the appointment and give you detailed advice. . Fill out a questionnaire about your trip. health situation from. Within the next three working days, you will receive a comprehensive medical consultation from a doctor experienced in travel medicine Written advice on recommended immunizations and precautions for your destination country as well as on the malaria, yellow fever and dengue fever situation on site. Example>> Your travel dossier
Telephone travel advice
Make an appointment for a medical consultation on the Answering your travel medicine questions as well as for current Vaccination recommendations for your destination. A doctor experienced in travel medicine will call you back at the telephone number you have given us at the agreed time and will give you detailed advice.