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Bacillary dysentery

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Bacillary dysentery
Other names: Shigella dysentery[1][2]
  • Top:Incidence rates, per 100,000, of BD for each five-year period in Vietnam, from 1999 to 2013
  • Bottom: Incidence rate and case-fatality rate of bacillary dysentery in China, 2004–2014[3]
SpecialtyInfectious disease
SymptomsTenesmus, bloody diarrhea, fever[4]
CausesVarious species of Shigella bacteria[4]
Risk factorsIndividuals with immune deficiency[4]
Diagnostic methodStool culture[5]
Differential diagnosisCDI, cholera, yersiniosis[3]
PreventionGood hygiene[4]
TreatmentAntibiotic, fluid replacement[4]

Bacillary dysentery is a type of dysentery, and is a severe form of shigellosis. It is associated with species of bacteria from the family Enterobacteriaceae.[6] The term is usually restricted to Shigella infections.[7]

Shigellosis is caused by one of several types of Shigella bacteria.[8] Three species are associated with bacillary dysentery: Shigella sonnei, Shigella flexneri and Shigella dysenteriae.[9] A study in China indicated that Shigella flexneri 2a was the most common serotype.[10]

Bacillary dysentery should not be confused with diarrhea caused by other bacterial infections. One characteristic of bacillary dysentery is blood in stool, which is the result of invasion of the mucosa by the pathogen.It is initially managed by maintaining fluid intake using oral rehydration therapy and antibiotics[4].

Signs and symptoms

Shigellosis is the general term for any infection caused by Shigella bacteria. The symptoms can range from mild, watery diarrhea to severe, bloody diarrhea with fever and abdominal cramps.Bacillary dysentery specifically refers to the more severe presentation of shigellosis where there is dysentery, which means the diarrhea contains blood and/or mucus. This indicates a more invasive infection of the intestinal lining by the Shigella bacteria, leading to inflammation and tissue damage.The presentation of Bacillary dysentery are as follows:[4][11][12]

Cause

Bacillary dysentery is caused by bacterial infections that inflame the intestines, leading to severe diarrhea mixed with blood. The most common culprits include: Shigella dysenteriae, S. flexneri, S. sonnei, and S. boydii[4]

Pathogenesis

Mechanism by which Shigella spp. cause pathogenicity in host[13]

Transmission is fecal-oral and is remarkable for the small number of organisms that may cause disease . Shigella bacteria invade the intestinal mucosal cells but do not usually go beyond the lamina propria. Dysentery is caused when the bacteria escape the epithelial cell phagolysosome, multiply within the cytoplasm, and destroy host cells.[12][14]

Shiga toxin causes hemorrhagic colitis and hemolytic-uremic syndrome by damaging endothelial cells in the microvasculature of the colon and the glomeruli, respectively. In addition, chronic arthritis secondary to S. flexneri infection, called reactive arthritis, may be caused by a bacterial antigen; the occurrence of this syndrome is strongly linked to HLA-B27 genotype, but the immunologic basis of this reaction is not understood.[12][14][15]

Diagnosis

As to the diagnosis for Bacillary dysentery we find that the following is done:[5][16]

  • Clinical exam
  • Medical history
  • Fresh stool collected
  • Blood test
Campylobacteriosis

Differential diagnosis

Salmonellosis is sometimes listed as an explicit differential diagnosis of bacillary dysentery.The DDx for Bacillary dysentery in an affected individual is as follows:[17][18]

Treatment

Dysentery is initially managed by maintaining fluid intake using oral rehydration therapy. If this treatment cannot be adequately maintained due to vomiting or the profuseness of diarrhea, hospital admission may be required for intravenous fluid replacement. Ideally, no antimicrobial therapy should be administered until microbiological microscopy and culture studies have established the specific infection involved. When laboratory services are not available, it may be necessary to administer a combination of drugs, including an amoebicidal drug to kill the parasite and an antibiotic to treat any associated bacterial infection.[4][5]

Anyone with bloody diarrhea needs immediate medical help; treatment often starts with an oral rehydrating solution—water mixed with salt and carbohydrates—to prevent dehydration. If Shigella is suspected and it is not too severe, the doctor may recommend letting it run its course—usually less than a week. The patient will be advised to replace fluids lost through diarrhea. If the infection is severe, the doctor may prescribe antibiotics, such as ciprofloxacin. Many strains of Shigella are becoming resistant to common antibiotics, and effective medications are often in short supply in developing countries. [19][5]

Epidemiology

Ratio of S. sonnei to S. flexneri isolated from 100 countries(1990–2014)[20]

As to epidemiology we find that Bacillary dysentery affects millions of people annually, mostly in developing countries.[3]

Bacillary dysentery, caused by Shigella species, is most prevalent in regions with poor sanitation . Some specific countries and regions where it's been a public health concern are:[3][20][21][22]

  • Northwest China(Gansu, Qinghai, and Xinjiang)
  • India, West Bengal and other eastern states have been endemic zones
  • Vietnam Kon Tum Province in Central Highlands had the highest incidence 1999 to 2013
  • Latin America,Shigella sonnei, once dominant in developed countries, is now expanding across industrializing regions in Latin America.

History

Dr Kiyoshi Shiga

The bacterium causing shigellosis is named after Kiyoshi Shiga, a Japanese researcher who discovered it in 1897.[23]

Research

No vaccine is available, however there are several Shigella vaccine candidates in various stages of research development that could reduce the incidence of dysentery in endemic countries, as well as in travelers with traveler's diarrhea.[24]

See also

References

  1. ↑ "Shigella dysentery and shigella infections". World Health Organization - Regional Office for the Eastern Mediterranean. Archived from the original on 2024-07-07. Retrieved 2025-07-14.
  2. ↑ Christopher, Prince RH; David, Kirubah V.; John, Sushil M.; Sankarapandian, Venkatesan (2010). "Antibiotic therapy for Shigella dysentery". Cochrane Database of Systematic Reviews (8). doi:10.1002/14651858.CD006784.pub4. ISSN 1465-1858.
  3. ↑ 3.0 3.1 3.2 3.3 Chang, Zhaorui; Zhang, Jing; Ran, Lu; Sun, Junling; Liu, Fengfeng; Luo, Li; Zeng, Lingjia; Wang, Liping; Li, Zhongjie; Yu, Hongjie; Liao, Qiaohong (18 November 2016). "The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004–2014". BMC Infectious Diseases. 16 (1): 685. doi:10.1186/s12879-016-1977-1. ISSN 1471-2334.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 "Centre for Health Protection, Department of Health - Bacillary Dysentery". www.chp.gov.hk. Archived from the original on 29 June 2023. Retrieved 20 July 2025.
  5. ↑ 5.0 5.1 5.2 5.3 Williams, Phoebe C. M.; Berkley, James A. (21 December 2018). "Guidelines for the treatment of dysentery (shigellosis): a systematic review of the evidence". Paediatrics and International Child Health. 38 (sup1): S50 – S65. doi:10.1080/20469047.2017.1409454.
  6. ↑ Dysentery,+Bacillary at the US National Library of Medicine Medical Subject Headings (MeSH)
  7. ↑ "bacillary dysentery" at Dorland's Medical Dictionary
  8. ↑ Yang F, Yang J, Zhang X, et al. (2005). "Genome dynamics and diversity of Shigella species, the etiologic agents of bacillary dysentery". Nucleic Acids Res. 33 (19): 6445–58. doi:10.1093/nar/gki954. PMC 1278947. PMID 16275786.
  9. ↑ "WHO | Diarrhoeal Diseases". Archived from the original on 15 December 2008. Retrieved 2008-12-19.
  10. ↑ Wang XY, Tao F, Xiao D, et al. (July 2006). "Trend and disease burden of bacillary dysentery in China (1991-2000)". Bull. World Health Organ. 84 (7): 561–8. doi:10.2471/BLT.05.023853. PMC 2627389. PMID 16878230. Archived from the original on 2016-05-31. Retrieved 2023-03-18.
  11. ↑ "Centre for Health Protection, Department of Health - Bacillary Dysentery". www.chp.gov.hk. Archived from the original on 29 June 2023. Retrieved 8 August 2023.
  12. ↑ 12.0 12.1 12.2 Palmer, Philip E. S.; Reeder, Maurice M. (8 November 2000). The Imaging of Tropical Diseases: With Epidemiological, Pathological and Clinical Correlation. Springer Science & Business Media. p. 165. ISBN 978-3-540-62471-4.
  13. ↑ Hmar, El Bethel Lalthavel; Paul, Sujata; Sharma, Hemanta Kumar (5 August 2024). "The role of Shigella spp. in propagating bacillary dysentery in humans and the prominence of nanotechnology in disease prevention". Future Journal of Pharmaceutical Sciences. 10 (1): 97. doi:10.1186/s43094-024-00676-4. ISSN 2314-7253.
  14. ↑ 14.0 14.1 Schroeder, Gunnar N.; Hilbi, Hubert (January 2008). "Molecular Pathogenesis of Shigella spp.: Controlling Host Cell Signaling, Invasion, and Death by Type III Secretion". Clinical Microbiology Reviews. 21 (1): 134–156. doi:10.1128/CMR.00032-07. Archived from the original on 22 June 2025. Retrieved 26 July 2025.
  15. ↑ Colmegna, Inés; Cuchacovich, Raquel; Espinoza, Luis R. (April 2004). "HLA-B27-Associated Reactive Arthritis: Pathogenetic and Clinical Considerations". Clinical Microbiology Reviews. 17 (2): 348–369. doi:10.1128/CMR.17.2.348-369.2004. Retrieved 26 July 2025.
  16. ↑ Sagaert, Xavier (2017). "Dysentery, Bacillary". Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. pp. 209–211. doi:10.1007/978-3-319-40560-5_1458. ISBN 978-3-319-40560-5.
  17. ↑ Shane, Andi L; Mody, Rajal K; Crump, John A; Tarr, Phillip I; Steiner, Theodore S; Kotloff, Karen; Langley, Joanne M; Wanke, Christine; Warren, Cirle Alcantara; Cheng, Allen C; Cantey, Joseph; Pickering, Larry K (29 November 2017). "2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea". Clinical Infectious Diseases. 65 (12): e45 – e80. doi:10.1093/cid/cix669. Archived from the original on 9 December 2023. Retrieved 17 July 2025.
  18. ↑ "Bacillary Dysentery". Archived from the original on 27 December 2008. Retrieved 2008-12-19.
  19. ↑ "About Shigella Infection". Shigella - Shigellosis. 26 June 2024. Archived from the original on 22 July 2025. Retrieved 23 July 2025.
  20. ↑ 20.0 20.1 Thompson, Corinne N.; Duy, Pham Thanh; Baker, Stephen (11 June 2015). "The Rising Dominance of Shigella sonnei: An Intercontinental Shift in the Etiology of Bacillary Dysentery". PLOS Neglected Tropical Diseases. 9 (6): e0003708. doi:10.1371/journal.pntd.0003708. ISSN 1935-2735.
  21. ↑ Lee, Hu Suk; Ha Hoang, T. T.; Pham-Duc, Phuc; Lee, Mihye; Grace, Delia; Phung, Dac Cam; Thuc, Vu Minh; Nguyen-Viet, Hung (27 June 2017). "Seasonal and geographical distribution of bacillary dysentery (shigellosis) and associated climate risk factors in Kon Tum Province in Vietnam from 1999 to 2013". Infectious Diseases of Poverty. 6 (1): 113. doi:10.1186/s40249-017-0325-z. ISSN 2049-9957.
  22. ↑ "Bacillary dysentery" (PDF). WHO. Retrieved 26 July 2025.
  23. ↑ Trofa, A. F.; Ueno-Olsen, H.; Oiwa, R.; Yoshikawa, M. (1 November 1999). "Dr. Kiyoshi Shiga: Discoverer of the Dysentery Bacillus". Clinical Infectious Diseases. 29 (5): 1303–1306. doi:10.1086/313437. Retrieved 23 July 2025.
  24. ↑ Girard MP, Steele D, Chaignat CL, Kieny MP (April 2006). "A review of vaccine research and development: human enteric infections". Vaccine. 24 (15): 2732–50. doi:10.1016/j.vaccine.2005.10.014. PMID 16483695.

External links

Classification
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