[Medical Q&A] How “intense” are the symptoms of bacillary dysentery?

Planner: Chinese Medical Association

Reviewer: Huang Lei, deputy chief physician, Fifth Medical Center, PLA General Hospital

Typical dysentery has an acute onset, fever and diarrhea, 10 to 30 bowel movements per day, and stools with mucus, pus and blood; nausea, vomiting, paroxysmal abdominal pain, mild abdominal tenderness, and a feeling of tenesmus (manifested as lower abdominal discomfort and a strong desire to defecate, but unable to do so). Patients have general fatigue and decreased appetite; infants and young children may sometimes have febrile convulsions.

Atypical dysentery may be accompanied by no fever or only a slight fever, mild diarrhea, loose stools, and only mucus but no pus or blood in the stool. The diagnosis can only be confirmed by a positive stool culture.

Toxic bacillary dysentery is a critical type of acute bacillary dysentery, mainly affecting children aged 2 to 7 years old! It has an acute onset and progresses rapidly. The child's body temperature can quickly rise to 40°C or above, accompanied by severe poisoning symptoms such as chills, chills, mental depression, and drowsiness. However, the intestinal symptoms of children are relatively mild. Toxic bacillary dysentery is mainly divided into the following 3 types: ① shock type, with symptoms of infectious shock, such as pale complexion, mottled skin, cold limbs, cyanosis of lips, decreased blood pressure, decreased urine volume, and impaired consciousness; ② cerebral type, with cerebral edema, manifested as irritability, drowsiness, coma, convulsions, pupil sizes, slow or absent light reflex, this type has a high mortality rate; ③ Symptoms of shock type and cerebral type appear at the same time. This type of condition is the most dangerous and has a high mortality rate!