bacillary dysentery

細菌性赤痢

WordNet

1. formed like a bacillus (同)bacillary, bacilliform, baculiform, rod-shaped
2. relating to or produced by or containing bacilli (同)bacillary
3. an infection of the intestines marked by severe diarrhea

PrepTutorEJDIC

1. 赤痢

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/02/29 09:41:28」(JST)

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Bacillary dysentery
Classification and external resources
ICD-10	A03.9
ICD-9	004
MeSH	D004405

Bacillary dysentery is a type of dysentery, and is a severe form of shigellosis.

Bacillary dysentery is associated with species of bacteria from the Enterobacteriaceae family. The term is usually restricted to Shigella infections.

Shigellosis is caused by one of several types of Shigella bacteria. Three species are associated with bacillary dysentery : Shigella sonnei, Shigella flexneri and Shigella dysenteriae. One study in China indicated that Shigella flexneri 2a was the most common serotype.

Salmonellosis caused by Salmonella enterica (serovar Typhimurium) has also been described as a cause of bacillary dysentery,^{[citation needed]} though this definition is less common. It is sometimes listed as an explicit differential diagnosis of bacillary dysentery, as opposed to a cause.

Bacillary dysentery should not be confused with diarrhea caused by a bacterial infection. One characteristic of bacillary dysentery is blood in stool, which is the result of invasion of the mucosa by the pathogen.

Pathogenesis

Transmission is fecal-oral and is remarkable for the small number of organisms that may cause disease (10 ingested organisms cause illness in 10% of volunteers, and 500 organisms cause disease in 50% of volunteers). Shigella bacteria invade the intestinal mucosal cells but do not usually go beyond the lamina propria. Dysentery is caused when the bacteria escape the epithelial cell phagolysosome, multiply within the cytoplasm, and destroy host cells. Shiga toxin causes hemorrhagic colitis and hemolytic-uremic syndrome by damaging endothelial cells in the microvasculature of the colon and the glomeruli, respectively. In addition, chronic arthritis secondary to S. flexneri infection, called Reiter syndrome, may be caused by a bacterial antigen; the occurrence of this syndrome is strongly linked to HLA-B27 genotype, but the immunologic basis of this reaction is not understood.

Diagnosis

Specimen: Fresh stool is collected

Culture: Specimen is inoculated on selective media like McConkey's agar, DCA, XLD agar. Selenite F broth(0.4%) is used as enrichment medium which permits the rapid growth of enteric pathogens while inhibiting the growth of normal flora like Esch. coli for 6–8 hours. Subculture is done on the solid media from selenite F broth. All the solid media are incubated at 37 degrees for 24 hours.

Cultural characteristics: Colorless (NLF) colonies appear on McConkey's agar which are further confirmed by gram staining, hanging drop preparation and biochemical reactions.

Treatment

Dysentery is initially managed by maintaining fluid intake using oral rehydration therapy. If this treatment cannot be adequately maintained due to vomiting or the profuseness of diarrhea, hospital admission may be required for intravenous fluid replacement. Ideally, no antimicrobial therapy should be administered until microbiological microscopy and culture studies have established the specific infection involved. When laboratory services are not available, it may be necessary to administer a combination of drugs, including an amoebicidal drug to kill the parasite and an antibiotic to treat any associated bacterial infection.

Anyone with bloody diarrhea needs immediate medical help. Treatment often starts with an oral rehydrating solution—water mixed with salt and carbohydrates—to prevent dehydration. (Emergency relief services often distribute inexpensive packets of sugars and mineral salts that can be mixed with clean water and used to restore lifesaving fluids in dehydrated children gravely ill from dysentery.)

If shigella is suspected and it is not too severe, the doctor may recommend letting it run its course—usually less than a week. The patient will be advised to replace fluids lost through diarrhea. If the shigella is severe, the doctor may prescribe antibiotics, such as ciprofloxacin or TMP-SMX (Bactrim). Unfortunately, many strains of shigella are becoming resistant to common antibiotics, and effective medications are often in short supply in developing countries. If necessary, a doctor may have to reserve antibiotics for those at highest risk for death, including young children, people over 50, and anyone suffering from dehydration or malnutrition.

No vaccine is available. There are several Shigella vaccine candidates in various stages of development that could reduce the incidence of dysentery in endemic countries, as well as in travelers suffering from traveler's diarrhea.

References

UpToDate Contents

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• 1. 赤痢菌感染：臨床症状および診断 shigella infection clinical manifestations and diagnosis
• 2. 資源の限られた国における成人の急性下痢に対するアプローチ approach to the adult with acute diarrhea in resource limited countries
• 3. 先進国に居住する小児の下痢へのアプローチ approach to diarrhea in children in resource rich countries
• 4. 先進国に居住する成人の急性下痢へのアプローチ approach to the adult with acute diarrhea in resource rich settings
• 5. 資源の限られた国での急性下痢の小児に対するアプローチ approach to the child with acute diarrhea in resource limited countries

English Journal

• Nonlinear and threshold of the association between meteorological factors and bacillary dysentery in Beijing, China.

• Li ZJ1, Zhang XJ2, Hou XX1, Xu S1, Zhang JS1, Song HB3, Lin HL4.
• Epidemiology and infection.Epidemiol Infect.2015 Dec;143(16):3510-9. doi: 10.1017/S0950268815001156. Epub 2015 Jun 1.
• Previous studies examining the weather-bacillary dysentery association were of a large time scale (monthly or weekly) and examined the linear relationship without checking the linearity assumption. We examined this association in Beijing at a daily scale based on the exposure-response curves using g
• PMID 26027678

• Investigation on the Synthesis of Shigella flexneri Specific Oligosaccharides Using Disaccharides as Potential Transglucosylase Acceptor Substrates.

• Salamone S1,2, Guerreiro C1,2, Cambon E3,4,5, Hargreaves JM1,2, Tarrat N3,4,5, Remaud-Siméon M3,4,5, André I3,4,5, Mulard LA1,2.
• The Journal of organic chemistry.J Org Chem.2015 Nov 10. [Epub ahead of print]
• Chemo-enzymatic strategies hold great potential for the development of stereo- and regioselective syntheses of structurally defined bioactive oligosaccharides. Herein, we illustrate the potential of the appropriate combination of a planned chemo-enzymatic pathway and an engineered biocatalyst for th
• PMID 26340432

• Co-administration of rIpaB domain of Shigella with rGroEL of S. Typhi enhances the immune responses and protective efficacy against Shigella infection.

• Chitradevi ST1, Kaur G1, Uppalapati S2, Yadav A3, Singh D1, Bansal A1.
• Cellular & molecular immunology.Cell Mol Immunol.2015 Nov;12(6):757-67. doi: 10.1038/cmi.2014.86. Epub 2015 Feb 2.
• Shigella species cause severe bacillary dysentery in humans and are associated with high morbidity and mortality. The Invasion plasmid antigen (IpaB) protein, which is conserved across all Shigella spp., induces macrophage cell death and is required to invade host cells. The present study evaluates
• PMID 25640657

Japanese Journal

• 細菌性赤痢 (特集 夏に知っておきたい細菌性胃腸炎)

• 臨床検査 58(7), 833-839, 2014-07
• NAID 40020132296

• A hybrid model for short-term bacillary dysentery prediction in Yichang City, China

• Japanese Journal of Infectious Diseases 63(4), 264-270, 2010-07
• NAID 40017214357

• A new paradigm of bacteria-gut interplay brought through the study of <bold>Shigella</bold>

• Proceedings of the Japan Academy, Series B 86(3), 229-243, 2010
• NAID 130000264076

Related Links

• What Is Bacillary Dysentery (Shigellosis)? - Diarrhea ...

Bacillary dysentery, also called shigellosis, is a potentially life-threatening and highly contagious bacterial infection of the colon. The main symptom is diarrhea. Learn more about what causes bacillary dysentery, diagnosis and ...

• Bacillary dysentery | definition of bacillary dysentery by ...

bacillary [bas´ĭ-lar″e] pertaining to bacilli or to rodlike structures. bacillary dysentery the most common and violent form of dysentery, caused by bacteria of the genus Shigella. It is most common in the tropics, the subtropics, and ...

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★リンクテーブル★

リンク元	「細菌性赤痢」
関連記事	「bacillary」「bacillar」

「細菌性赤痢」

　　[★]

dysentery

英

bacillary dysentery, shigellosis

関

赤痢、アメーバ赤痢、感染症法

概念

• 汚染された飲食もつなどを介して感染し(糞口感染)、志賀毒素により消化管を障害する。

特徴

• 三類感染症

病原体

• Shigella属　←　鞭毛を持たない

• D群赤痢菌 Shigella sonnei　　　：日本で最多。
• A群赤痢菌 Shigella dysenteriae：もっとも重症な赤痢の原因菌
• Shigella flexneri　　　：輸入例でみられる

潜伏期間

• 1-5日

感染経路

• 糞口感染

病態

• 菌体数10個程度で感染が成立。
• 赤痢菌は腸管上皮細胞に進入して炎症を惹起し、表層粘膜の破壊と粘膜潰瘍を起こさせる　→　細胞質内に進入してアクチンの重合を利用して動き回る　→腸管上皮の潰瘍を伴った急性炎症症状(粘膜下層よりも深く拡散することはごくまれ　→　敗血症とならない(⇔サルモネラ属)　))
• 大腸(特にS状結腸)(ときに、回盲部末端)：粘膜の出血性化膿炎、次いで潰瘍、壊死を来す

症状

• 腹痛を伴うテネスムス、膿・粘血便の排泄
• 悪寒・発熱、腹痛、テネスムス、粘血・脳性下痢便。

身体所見

• 腹部陥没、S状結腸を圧痛性索状物として触知する。

治療

• 薬物療法

• 1. ニューロキノロン系抗菌薬(1st choice)
• 2. 小児や1.禁忌例にはホスホマイシン

「bacillary」

　　[★]

• adj.

• 桿菌性の、桿菌の

関

bacillar、bacilli、Bacillus

「bacillar」

　　[★]

• adj.

• 桿菌性の

関

bacillary