diarrhoea with bloody mucous

A couple of ages 23 and 22 arrive at your clinics this morning reporting severe abdominal cramps, gross bloody diarrhea with mucous, nausea and fever for 48 hours. On further questioning, they said that they recently come back from their village and drinking raw water from the well.

1)What is the most likely bacteria that can cause above symptoms

2)What is the possible route of infection

3)What investigation that you would like to perform?

4)Outline the pathogenesis of above symptoms.

5)Outline the treatment




Anwer


1)What is the most likely bacteria that can cause above symptoms

a)Bacillary dysentry
-Shigella species (S. dysenteriae, S. flexneri, S. boydii, S. Sonnei)
-Campylobacter jejuni
-Enteroinvasive E.Coli
-Yersinia enterocolitica

b)Amoebic dysentry
-Entamoeba hystolytica

Dysentry

- frequent passage of stools containing blood& mucous accompanied with painful straining and defecation

2)What is the possible route of infection
-Faecal-oral route (crowded population, poor quality water supply, inadequate sewage disposal)


3)What investigation that you would like to perform?
-Stool microscopy
-Stool culture (Mac Conkey, DCA agar- colorless)
-Serological test (serotyping with O Ag)
-Gram stain (shigella and campylobacter is both gram negative rod)
-Stool culture on Campy agar (to exclude campylobacter)

4) Click on the image for the larger view




5)Outline the treatment
-Fluid and electrolytes replacement
- Antimicrobial (ampicillin/amoxacillin, Ciprofloxacin, Co trimoxazole, Cephalosporin)