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Dysentery

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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