Dysentery
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Transcript of Dysentery
DANGER SIGN:
DYSENTRY
Disediakan Oleh : Nassruto.
LEARNING OBJECTIVE:• Define the meaning of Dysentery.• Explain the etiology of Dysentery.• Describe the pathofisiology of Dysentery
infection.• Describe the clinical manifestation of
Dysentery. • Explain the management of Dysentery
treatment.
DEFINITION:• Dysentery is diarrhea presenting with loose frequent
stools containing blood.• WHO – 2000.
• An inflammation of the intestine, especially of the colon, that may be caused by chemical irritants, bacteria, protozoa, parasites.
• Mosby’s Dictionary.
• Characterized by frequent and bloody stools, abdominal pain and tenesmus.
• ( Jangkitan akut ke atas usus besar yang disebabkan oleh shigella yang bercirikan cirit-birit dan najis mengandungi darah ).
ETIOLOGY:
• Causes agent is by bacteria:
• Shigella dysenteriae.• Shigella Flexneri.• Shigella sonnei.
ETIOLOGY:• Agent is bacteria.
• Route is mouth.
• Factor is contaminated food and H20 with faeces.
• Direct transmission via Oral faecal route or by vectors.
• Mostly easy infected to the children and food providers.
PREVALEN:
• Spread to world wide.
• Endemic plague to the poor country, highly population / crowded, World war / Disaster, Sanitation unstructured.
• Common case infected to the children.
PREVALEN:
• Window period is 1 – 4 days, Short time.
• Period of infected is from the first expose until no more bacteria Shigella detection in the feaces.
• Sign of diarrhea is the active time to be infected.
PATHOFISIOLOGI:
• Contaminate food & H20 by infected faeces.• Bacteria Shigella enter to the gut.• Growth in the small intestine.• Spread to the colon, inflame the epithelium
mucosa cell and produce or secrete toxin.• Break through the colon wall & necrosis the
epithelium cell causes haemorrhage, more mucus, purulent at the epithelium surface.
• At the end, ulcer colon occurs.
MANIFESTATION:
• Sudden onset, had headache, malaise, anorectic and mild fever.
• Abdominal discomfort, more severe pain & cram, at last colicky pain.
• 4 - 5 x diarrhea sign in the first day infected.• Frequency of diarrhea increase 1-2 days.
MANIFESTATION:
• Watery stools.
• Brown-yellowish color.
• Less stools but more mucus & blood.
• Diarrhea will continuously in period of time - 1/52 or more.
• Tenesmus.
Tenesmus:• Persistent spasms.• Internal pressure and burning sensation
intra abdomen and opening anus.• After past motion.• Ineffectual to empty the bowel.• Common in inflammatory bowel disease
and irritable bowel syndrome.
MANIFESTATION:
• Tenderness abdomen.• Convulsions.• Lethargy.• Dehydration:• Dry mouth, tongue, skin terger high, sunken
eye etc.• Rectal prolapse.
DETACTION:
• If have diarrhea: ( Look and feel ).• Look general condition:• Lethargic/ restless / irritable / unconscious.• Eyes.• Able to drink.• Pinch the skin.• Is there blood in the stool?.• Investigate.
Investigation:• Swab rectal for culture: To fine out the causes agent.
DIFFERENT DIAGNOSIS:
• Ameobiasis.• Ulcerative colitis.• Crohn’s colitis.• Ischaemic colitis.• Diverticulitis.• Karsinoma colon.
Complications:
• Intestinal hemorrhage.• Perforation.• Peritonitis.• Prolaps rectum.• Arthritis.• dehydration – to children.
TREATMENT AND MANAGEMENT.
• Admitted for barrier nursing, complete rest.• Soft diet / fluid diet- less fiber to reduce burden
function of intestine.• Encourage to increase fluid intake.• Intravenal infusion to control the electrolyte
balance.
TREATMENT AND MANAGEMENT:
• Medication:• ORS.• Antibiotic:
• Ampicillin.• Adult : 500mg qid x 5/7.• Children: 125mg / 5 ml. – 62.5 mg.• co-trimoxazole / Metronidazole• Cephalosporins ( cefalexin, cefamandole ).
• Symptomatic treatment.
TREATMENT AND MANAGEMENT:
• Health Education:• Personnel hygiene.• Environmental hygiene.• Good sanitation / purification water supply.• Food Handling care.• Complete cooking.
PROGNOSIS:
• Early treatment is important to prevent complication occur and safe life.
• Common mortality in infant / children / old age.
• Effect to less body immune response due to less nutrition.
S.1
Kanak-kanak 9 tahun dibawa ke klinik anda mengadu mengalami diarrhea bercampu darah dan merasa pedih selepas membuang air besar.
MRK.
A. Senaraikan empat ( 4 ) agen penyebab berlaku disenteri.
4 mrk.
B.Jelaskan tiga ( 3 ) aspek pendidikan kesihatan yang perlu ditekankan kepada kes di atas.
6mrk.
GERAK KERJA 1
