Dysentery

Introduction Dysentery, the ancient name of the intestines, stagnation. It is one of the acute intestinal infectious diseases. Clinically, fever, abdominal pain, urgency, and stool pus and blood are the main symptoms. If the epidemic is infected, the incidence is sharp, accompanied by sudden high fever, dizziness, convulsions, and plague. At the beginning of dysentery, I saw abdominal pain first, followed by squatting, ranging from several times to dozens of times. It occurs mostly in the summer and autumn seasons. It is caused by the evil of dampness and heat, internal injury to the spleen and stomach, spleen and loss of health, and loss of stomach and stagnation.

Cause

Cause:

When dysentery is caused by dysentery bacilli, endotoxin is produced to damage the intestinal mucosa, and multi-nuclear cells infiltrate in the lesion to form an abscess or ulcer. The mesenteric lymph nodes of the lesion were hyperemic.

In the epidemic season, there is a history of dysentery contact or a history of unclean diet, fever, sticky pus and bloody stools, and urgency and other symptoms should be considered. In the summer and autumn seasons, those with sudden high fever, convulsions, pale complexion, cold extremities, and fine pulse should consider poisonous bacillary dysentery.

an examination

Related inspection

Conventional enteroscopy

Dysentery

The dysentery is divided into white sputum, red sputum, red sputum, sputum, and rest.

1. White peony: Wet is better than heat, evil is fragrant, and its symptoms are sticky and white, or like bean juice, heavy after abdominal pain, chest and abdomen boring, white or yellow, or wet.

2. Red peony: Heat is better than wet, evil bloody blood, its symptoms are yellow red, or pure red, or like fish brain, abdominal pain, urgency and heavy, urinary red heat, polydipsia, or high fever, also A zealous name.

3. Red and white sputum: damp heat accumulation, qi and blood two injuries, the symptoms are red and white, like fish brain, abnormal smell, polydipsia, abdominal pain, pulse and count, also known as hot and humid.

4. mouth : red, vomiting, can not eat, chest boring, Shenpi fatigue. It is often caused by damp heat, sputum appetite, or turbidity to block stomach cramps.

5. Resting : ,

Inspection measures

In acute patients, the total number of white blood cells and neutrophils may increase, and there may be a left shift of the nucleus. Chronic patients may have anemia. Typical patient stool microscopic examination showed a large number of pus and red blood cells, as well as phagocytic cells, atypically only a few white blood cells. Choosing stools with pus and blood is easy to get a positive result. X-ray and sigmoidoscopy can be used for the examination and differential diagnosis of chronic bacillary dysentery.

Differential diagnosis

Attention should be paid to the identification of the following diseases:

1 Pathogenic E. coli enteritis occurs mostly in children under 2 years of age, with a high incidence rate of 5-8 months. There may be mucus in the feces, which has a stench smell. It is thin and thin, and it has a lot of stools. It is easy to cause dehydration and acidosis. Microscopic examination can have white blood cells and pus cells, which can be diagnosed by bacterial culture of feces.

2 Salmonella enteritis often occurs in families or groups, vomiting is more common, stool mucus is more than pus, often green jelly. The weight of the urgency is relatively rare, and the culture of fecal bacteria can be diagnosed.

3 viral diarrhea is more common in children under 2 years of age. Acute onset, accompanied by symptoms of upper respiratory tract infection, stool is watery or egg-flower soup, can have a small amount of mucus, no odor. Fecal bacterial culture is negative, and immunoelectron microscopy, enzyme-linked immunosorbent assay, and polyacrylamide gel electrophoresis detection, as well as virus isolation, are helpful in diagnosing this disease.

4 Amoeba dysentery is more common in the South, mostly in older children. The onset is slower, the frequency of bowel movements is more, but there is no urgency and heavy, the stool has blood and mucus, and it is purple-red jam-like. The fresh stool mucus microscopy can find the amoeba trophozoite.

6 hemorrhagic enteritis is an acute onset, with abdominal pain, bloating, vomiting and other symptoms. The stool is bloody, and shock often occurs in the late stage. Fecal culture is negative, and X-ray examination is helpful in diagnosing the disease.

6 Epidemic encephalitis is the same season as poisoning dysentery. When the poisoned dysentery lacks intestinal symptoms, the two are similar. Cerebrospinal fluid examination is helpful for the diagnosis of epidemic encephalitis; while warm saline enema, microscopic examination or culture, can confirm the diagnosis of poisoning dysentery.

7 Cholera and cholera in the epidemic season come from the epidemic area. There is a history of edible aquatic products, acute vomiting and diarrhea, and a large amount of water. It is a water-like sample. The bacterial culture of feces can help diagnose.

8 intestinal tuberculosis can appear pus and bloody stools, similar to dysentery, but its incidence is slow, there is a history of tuberculosis, there may be afternoon fever and night sweats, tuberculin test positive; fecal culture is helpful for diagnosis.

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