Pengenalan asas mengenai DYSENTERY

2. DANGER SIGN:

3. DYSENTRY
Disediakan Oleh : Nassruto.

4. 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.

5. 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
).

6. ETIOLOGY:
• Causes agent is by bacteria:
• Shigella dysenteriae.
• Shigella Flexneri.
• Shigella sonnei.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. MANIFESTATION:
• Watery stools.
• Brown-yellowish color.
• Less stools but more mucus & blood.
• Diarrhea will continuously in period of time
- 1/52 or more.
• Tenesmus.

13. 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.

14. MANIFESTATION:
• Tenderness abdomen.
• Convulsions.
• Lethargy.
• Dehydration:
• Dry mouth, tongue, skin terger high, sunken
eye etc.
• Rectal prolapse.

15. 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.

16. Investigation:
• Swab rectal for culture:
To fine out the causes agent.

17. DIFFERENT DIAGNOSIS:
• Ameobiasis.
• Ulcerative colitis.
• Crohn’s colitis.
• Ischaemic colitis.
• Diverticulitis.
• Karsinoma colon.

18. Complications:
• Intestinal hemorrhage.
• Perforation.
• Peritonitis.
• Prolaps rectum.
• Arthritis.
• dehydration – to children.

19. 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.

20. 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.

21. TREATMENT AND MANAGEMENT:
• Health Education:
• Personnel hygiene.
• Environmental hygiene.
• Good sanitation / purification water supply.
• Food Handling care.
• Complete cooking.

22. 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.

23. 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.
6
mrk.
GERAK KERJA 1