（参考翻译）05 20170323.Yuzebo.Bacillary dysentery.pptVIP

* IM:intramuscular injection μg :microgram Mg：milligram millimeters of mercury 毫米汞柱 * Shigellosis * Shigellosis: Possible complications Intestinal perforation 肠穿孔 :Rarely occurs Septicemia 败血症: usually caused by B serogroups (S. flexneri) Reactive Arthritis 反应性关节炎---Reiters syndrome (after 2 weeks of Shigellosis) Several joints are usually affected —especially the knees. It also occurs after genital tract 生殖道 infection(such as gonorrhea 淋病) HUS: Hemolytic Uremic Syndrome 溶血性尿毒综合征(caused by S. dysenteriae or EHEC-enterohemorrhagic 肠出血的 E. coli O157) hemolytic anemia 溶血性贫血, and acute renal failure. * Shigellosis * 7. Diagnosis Epidemic data (exposed to patients) Clinical feature(typical type) Laboratory findings Aiming to toxic dysentery, checking stools by digital rectal examination 直肠指检(DRE) or cold salt liquid enema 冷盐水灌肠 is the most important diagnosis method. * Shigellosis * 8. Differential diagnosis Acute dysentery: Amebic dysentery 阿米巴痢疾(see below table) Chronic dysentery: colitis 结肠炎,corn’disease,tumor Depend on colon endoscope 直肠内窥镜 and biopsy Toxic dysentery:encephalitis(such as encephalitis B 乙脑) The onset of toxic dysentery is more quickly than encephalitis B. Toxic dysentery is accompanied with circulation failure or shock. checking stools by cold salt liquid enema can provide valuable clue 线索. * Shigellosis * amebic dysentery Shigellosis General condition mild，lower fever, toxemia unusually severe, high fever, toxemia usually Stool frequency less, 2~10 times/day more,10~30 times/day Stool volume More/each time Less/each time Tenesmus mild or without Obviously Site of press-pain right inferior abdomen left inferior abdomen Stool appearance more fecal and less watery,contain mucus ,—like fruit paste 果泥 with uncomfortable odors less fecal, contain purulent and blood,without special odors 气味 Stool under microscope Fewer WBC,More RBC,Special crystal More WBC, Fewer RBC Stool culture Without Shigella Sh