a) Limitation of Dysentery
dysentery syndrome consists of a collection of symptoms of diarrhea with blood and mucus in the stool and the presence of tenesmus
b ) Etiology of Dysentery
Bloody diarrhea can be caused by groups of causes of diarrhea , such as by infection with viruses, bacteria , parasites , lactose intolerance , cow's milk protein allergy .
But most of dysentery caused by infection .
Transmission is fecal - oral contact and contact person to person or person with a household appliance .
spread through food and water
The main cause of dysentery is Shigella , Salmonella , compylobacter jejui , Escherichia ( E. coli ) , and Entamoeba histolytica . Ummunya severe dysentery caused by shigellia dysentery , sometimes it can also be caused by shigella flexneri , Salmonella and enteroinvasl veEcolo ( EIEC ) .
c ) The pathogenesis of dysentery
Shigella , ymenghasilkantoksin and double or resistant to antibiotics
Giving spasmolytic increase the likelihood of toxic megacolon .
antibiotics where germs resistant to antibiotics will aggravate the clinical manfestasi and slows secretion causing germs in the stool of patients .
Shigella exotoxin produce a group called shigatoxin ( ST ) group this toxin has three effects : neurotoxic , sitotpksik and enterotoksik .
Some other enteric bacteria produce a toxin with a similar effect , called shiga- like toxin
This toxin has two units are functional units , which give rise to the riot . , And units that determine affinity toxin binding to specific receptors .
The difference is this unit that sets the shape of the complications that occur .
The complications that arise as a result of toxin are dose related .
can cause more severe damage when working with the Endotoxin : Lipopoly sacharide ( LPS ) derived from bacteria
lowered immunity , increased activity of T cells and suppresser penekakan makrophag phogositosis capabilities .
shigella infections lead to loss of protein through the gut that reflected the emergence albuminemia Hypo and Hypo transferinemia .
Dysentery , especially yangdisertai symptoms of fever , also accompanied by a decrease in appetite . This will simplify the circuit patogenensis munculnyakurang protein energy ( PEM ) and secondary infection .
d ) Clinical Dysentery
generally preceded by watery diarrhea , then the second or third day of blood emerging , with / without mucus ,
abdominal pain followed by the appearance of hot tenesmus
loss of appetite
body felt weak
e ) Complications of Dysentery
toxic megacolon
perforation
Hypoglycemia
hyponatremia
encephalopathy
Sepsis
Pneumonia
uremi hemolytic syndrome
PEM
f ) Treatment of Dysentery
given antibiotics early stage :
cotrimoxazole 2x960 mg for 2mggu
or ampicillin at a dose of 4x750 mg a day diving 2mggu .
REMEMBER CONTROL ! !
alternative
2x500mg ciprofloxacin for 3hr
Or erythromycin 4x250mg 5d
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