Dysentery : Signs, Symptoms, Diagnosis, Treatment, Nursing care, Preventive, Control measures

Dysentery:

 

It is an infectious disease in which the patient passes stools with mucus and blood. The infectious microorganisms enter the body through the contaminated food and water and causes inflammation of the bowels. It may be bacillary dysentery or amoebic dysentery.

 

    A.Bacillary Dysentery

 

It is caused by bacteria which are swallowed in food, water or milk contaminated through flies or by direct contact with faeces of infected persons. It may occur in epidemics. It is dangerous in infants and in very old people.

 

The incubation period is 1-7 days.

 

Signs and symptoms:

 

1.     Fever, vomiting and abdominal pains.

 

2.     The patient always wants to have a motion

 

3.     Blood stained and mucous stool is passed.

 

4.     There may be dehydration.

 

5.     There is an urge to pass stools always

 

Diagnosis:

 

A stool specimen for microscopic study to identify the causative organisms.

 

Treatment and nursing care:

 

1.     Replace fluid loss by oral rehydration fluid.

 

2.     Infants should continue breast feeding.

 

3.     The doctor may order Antibiotics.

 

Preventive and control Measures:

 

1.     Isolation of patient, and disinfections of faces and soiled articles.

 

2.     Sanitary disposal of faeces.

 

3.     Safe drinking water.

 

4.     Fly control and protection of food.

 

5.     Food hygienic especially in preparing and handling food

 

B. Amoebic dysentery:

 

It is caused by a parasite called Entamoeba Hystalytica. It enters the body through contaminated food and water.

 

The incubation period is 3 to 4 weeks.

 

Signs and symptoms:

 

1.     Blood and mucus passed in large stools alternating with constipation.

 

2.     Dull pain on the right side of the abdomen.

 

3.     The persons will become anaemic

 

4.     Sometimes there is an acute attack of diarrhea.

 

5.     The infected person may develop liver abscess.

 

Diagnosis:

 

It is by the presence of E.H (warm) specimen of faces examined amoebae or cysts in a fresh with a microscope.

 

Treatment and nursing cure:

 

Tablet Metroniadazole as per prescription.

 

Preventive and control measures:

 

Same as given for bacillary dysentery,

 

Carriers should be identified and treated

 

C. Poliomyelitis:

 

This is also called infantile paralysis because it more often affects children and causes paralysis. It is caused by a virus, which enters the body through contaminated food and water and attacks the nerves.

 

The incubation period  4-7 days,

 

Most children are infected with poliovirus at sometime, but most of them have no symptoms. Some children have a few days of fever and painful muscles and then recover. Some get a meningeal type of which lasts a few days and they recover in most cases.

 

Signs and Symptoms:

 

1.     Polio is usually recognized only when the child stops walking and one of the legs are weak.

2.     Before this manifestation the child may have had a cold and fever, neck stiffness and mild diarrhoea for a few days.

 

3.     Paralysis may affect one or both legs, arms and in severe

 

a.     cases also    the diaphragm causing difficulty with breathing.

 

4.     The paralysis stops getting worse when the fever stops.

 

5.     Some patients' recover completely in about 6 weeks, but many are left with permanent paralysis and perhaps deformity.

 

Treatment and nursing care:

 

1.     There is no specific treatment for poliomyelitis.

 

2.     If the child has pain, give him aspirin, or paracetemol.

 

NO injections are allowed.

 

The infected person should be kept at bed rest with the affected limb supported, and splinted if necessary.

 

After 10 days the mother should be taught to do passive exercise for five minutes for 5 times a day.

 

If paralysis continues, arrange for physiotherapy.

 

Preventive and control measures:

 

Oral polio vaccine (O.P.V) for all infants and children according to the National Immunisation Schedule:

 

a.     Sanitary latrines and safe drinking water for all.

 

b.     Isolation of cases and disinfection.

 

c.      Search for polio cases especially among children.

 

d.     During an epidemic, avoid surgery of children' s nose and throat, and avoid D.P.T vaccine ( Diptheria polio and tetanus) immunization.