Dysentery is an acute or chronic disease of the large intestine of humans, characterized by:
• Frequent passage of small watery stools often contaminated with blood and mucus and accompanied by severe abdominal cramps.
• Ulceration of the wall of the intestine may occur.
Although many severe cases of diarrhea have been called dysentery, the word properly refer to a disease caused by either a specific amoeba, Entamoeba histolytica, or a bacillus that infect the colon.
Amebiasis can mimic ulcerative colitis and special care should be taken to distinguish the two diseases.
Amoebic Dysentery - It occurs when E. histolytica trophozoites invade the wall of the large intestine and multiply in the sub mucosa, forming large flask shaped ulcers. The amoebae ingest the red blood cells from the damaged capillaries.
Amoebic dysentery is endemic in many tropical countries but is attributable more too unsanitary conditions than to heat. It is most common type of dysentery.
Amoebic Liver Abscess - It occurs occasionally E. histolytica amoeba is carried to the liver in the portal circulation and form abscesses usually in the right lobe. Amoebic liver abscesses are more common in adults than in children with a higher frequency in adult men (3 to 1 rate).
Amoebic liver abscess includes:
• Pain and tenderness of the liver
• Wasting weakness
• Fever with chills
• Night sweats
• Patients with large or multiple abscesses may become jaundiced and anemic
• Usually a raised white cell count with neutrophilia
• Significantly raised ESR
Bacillary dysentery - It is caused by certain nonmotile bacteria of the genus Shigella. This form of dysentery is also most prevalent in unhygienic areas of the tropics but, because it is easily spread, sporadic outbreaks are common in all parts of the world. This dysentery is usually self-limiting and rarely manifests the more severe organ involvement characteristics of amoebic dysentery. Bacillary dysentery is spread by contaminated water, milk and food. Feces from active cases and those from healthy carriers as well contain immense number of the disease producing bacteria. Flies carry the bacteria on their feet or in their saliva and feces and deposit them on food; ants are also believed to spread the disease.
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