Dysentery is infectious disease affecting the intestines that is quite rare in developed countries. However, it used to be very common in the past and epidemics of bacillary dysentery spread during war periods in military collectives and POW camps.


The classic bacillary dysentery is caused by bacterium known as Shigella dysenteriae. The bacteria settle and multiply in the colon and they are excreted with the faeces. Therefore, sick person is the carrier who transmits the disease. The disease spreads by close contact with the sick person and by food and water contaminated with the bacteria. Shigella is incredibly infectious and only 1000 swallowed bacteria cells (!) may start the infection. The major risk of dysentery epidemics is low level of hygiene and inadequate food and water processing.


The bacteria infect the colon causing intestinal symptoms that occur several days after the infection. The disease manifests with abdominal pain and diarrhea. The diarrhea is rather strong and the stool may contain blood or mucus. Weakened individuals and the elderly may be threatened by dehydration and mineral imbalance. Severe cases of infection may even cause perforation of the intestine and peritonitis, which can progress into sepsis.


The suspicion may grow in a patient with sudden and strong diarrhea with blood and mucus in the stool. The blood tests usually show classic signs of bacterial infection including elevated sedimentation rate and CRP. The confirmation can be done by microbiological examination of the stool that finds the presence of bacteria.


The best way of prevention is proper hygiene when handling sources of food and water. In developed countries, the risk of dysentery epidemics is minimal.


Similarly to other intestinal infections, even the treatment of dysentery is rather symptomatic and includes bed rest and cautious hydration to prevent dehydration and imbalance of the internal environment. Severe cases may need administration of antibiotics.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources