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Diagnosis of dysentery (shigellosis)
Last reviewed: 23.04.2024
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Diagnosis of dysentery (shigellosis) 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.
The bacteriological method is most widespread. The best results are obtained by sowing feces directly at the bedside of the patient, before the appointment of antibacterial therapy, and with the delivery of the material to the bacteriological laboratory within the first 2 hours from the moment of collection. For the study, feces particles containing pathological impurities, but not blood, are chosen. The biomaterial is sown on selective media: Ploskireva, Levina, etc. Negative result of bacteriological examination of feces can be given on the 3-5th, and positive, as a rule, on the 5th-7th day from the moment of delivery of the material to the bacteriological laboratory. The frequency of positive results (seeding and identification of the pathogen), even with typical clinical manifestations of shigellosis, does not exceed 60-70%.
Serological methods of diagnosing dysentery (shigellosis), as a rule, are used in doubtful cases and with negative results of bacteriological examination of feces. Determine the titer of specific antibodies in the patient's serum and antigen in the bowel movements. To determine the titer of antibodies, usually RIGA is used, more rarely - RPGA or RA. As antigens take suspension of daily Shigella culture (RA) or a scintigraphic diagnostic kit from shigella Zoyne and Flexner (RPGA, RIGA). Positive diagnostic antibody titre when shigellosis is Sonne 1: 100, and for Flexner shigellosis 1: 200. More credible should be considered the growth of antibody titres in dynamics.
For rapid diagnosis, ELISA and latex agglutination reaction are used.
Differential diagnosis of dysentery (shigellosis)
Dysentery (shigellosis) in young children must be differentiated with "simple dyspepsia", salmonella, staphylococcal enterocolitis, enteropathogenic escherichiosis. Surgical pathology of the abdominal cavity, etc.
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