Shigellosis (dysentery) in children

Shigellosis (dysentery) is an acute infectious disease of a person with an enteral mechanism of infection caused by bacteria of the genus Shigella. Clinically, the disease manifests itself as a colitis syndrome and symptoms of general intoxication, often with the development of primary neurotoxicosis.

ICD-10 code

• A03.0 Shigellosis caused by Shigella dysenteriae.
• A03.1 Shigellosis caused by ShigellaJlexneri.
• A03.02 Shigellosis caused by Shigella boydii.
• AOZ.Z Shigellosis. Called Shigella sonnet
• A03.8 Another shigellosis.
• A03.9 Shigellosis, unspecified.

More than 50 species of human shigella and animals (monkeys) are known.

Epidemiology of shigellosis in children

Shigellosis is one of the most common acute intestinal infections in children, which causes both sporadic cases and epidemic outbreaks. The share of children among all those with shigellosis is 60-70%, mostly children aged 2-7 years, especially those who attend preschool and school. Children of the first year of life suffer from shigellosis much less often.

The source of infection is only a person - a patient or a bacteriovirus. Especially patients with mild and erased forms of the disease.

Depending on the transmission factors (hands, water, food, flies, etc.), contact, food, water, milk and other pathways of infection are isolated.

[1], [2], [3], [4], [5], [6],

The causes of shigellosis in children

Shigella are morphologically indistinguishable from each other - they are Gram-negative fixed sticks, capsules and flagella do not, spores do not form, multiply easily on ordinary nutrient media, facultative anaerobes.

The disease develops only when the pathogen enters the digestive tract through the mouth. The introduction of live shigella culture directly into the rectum does not cause disease.

What causes dysentery (shigellosis)?

Symptoms of dysentery in children

The incubation period depends mainly on the pathway of infection and the number of pathogens. Usually it ranges from 6-8 hours to 7 days, an average of 2-3 days.

The disease almost always begins acutely, with an increase in body temperature to 38-39 ° C and above, which lasts no more than 3-5 days. Often during the first day of the disease, a single and repeated vomiting is noted, which is usually not repeated the next day. Vomiting, lasting 3 days or more. Uncharacteristic for shigellosis.

Symptoms of dysentery (shigellosis)

Classification of shigellosis (dysentery)

The classification is based on the division of shigellosis according to etiology (Shigellosis Sonne. Shigellosis Flexner, etc.). And also by type, gravity and flow.

In typical cases of shigellosis, the main clinical manifestations are clearly expressed, and in the first place the colitis syndrome with the phenomena of "distal colitis" and the neurotoxicosis syndrome. Depending on the presence and severity of the manifestations of infectious toxicosis and the depth of the lesions, the gastrointestinal tract is characterized by an easy, moderate and severe form of the disease. The severity of the disease can be due to the prevalence of various symptoms:

• Type A - prevalence of symptoms of infectious toxicosis;
• type B - the severity of local manifestations (the frequency and nature of the stool, pain syndrome, tenesmus, etc.);
• type B - mixed type - the same severity of general toxic and local syndromes.

The division of shigellosis into types A, B, and B is given only for typical medium-heavy and heavy forms.

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Diagnosis of shigellosis in children

The diagnosis is established on the basis of clinical and epidemiological data with mandatory laboratory confirmation.

Using PCR, as well as bacteriological and serological methods of investigation. Coprologic method, as well as results of sigmoidoscopy. Have an auxiliary value.

Diagnosis of dysentery (shigellosis)

[12], [13], [14], [15]

Treatment of dysentery in children

Treatment can be done at home. Antibiotics are usually prescribed in severe forms and preferably taking into account the sensitivity of shigellas circulating in the area (region). Apply gentamycin, polymyxin M. Ampicillin, amoksiklav, amoxicillin, neviramon. With medium and light forms of shigellosis, it is better to prescribe nitrofurans (furazolidone, nifuroxazide), 8-hydroxyquinolines (chlorohinaldol, etc.). The course of treatment should not exceed 5-7 days.

Treatment of dysentery (shigellosis)

Prevention of shigellosis

Prevention shigellosis (dysentery) is based primarily on strict compliance with the technology of cooking, storage and timing of food and anti-epidemic regime in preschool and school institutions.

Significance is the early diagnosis and isolation of the patient (or shigella bacilli) in a hospital or at home. All patients with shigellosis and bacillary discharges are filled with emergency notification in SES (Form No. 58). In the focus of infection after isolation of the patient , the final disinfection is carried out. Contact children are assigned medical supervision for 7 days, quarantine is not imposed. In the focus of infection during the observation period, current disinfection is carried out, strict control of the children's chair is carried out, in the nursery groups of the kindergarten there is a table of chairs. Each child with bowel dysfunction must be isolated and examined with a bacteriological method. It is also used inoculation from Sonne's dysentery.

Prevention of dysentery (shigellosis)