Bacillary Dysentery

Bacillary dysentery is an intestinal infection, most commonly caused by Shigella bacteria, characterised by diarrhoea containing blood and mucus. It spreads through contaminated food, water, and poor hand hygiene, and can cause outbreaks in crowded settings.

• Frequent loose stools containing blood and mucus
• Abdominal cramps and pain, often with straining and a strong urge to defecate (tenesmus)
• Fever
• In severe cases: dehydration and, particularly in young children, risk of complications such as rectal prolapse or severe systemic illness

• Most commonly caused by Shigella species, and occasionally other bacteria.
• Spread through the faecal-oral route via contaminated food or water, or direct contact with an infected person.
• Risk is increased by poor sanitation, unsafe water supply, overcrowding, and inadequate hand hygiene.

• Mainly a clinical diagnosis based on the presence of blood and mucus in loose stools together with fever and abdominal cramps.
• Stool microscopy and culture, where available, can identify the causative organism, particularly in outbreaks or severe/persistent cases.
• Assessment for dehydration is essential in every case, especially in young children.

Oral rehydration solution is given to prevent or correct dehydration in all cases, with intravenous fluids reserved for severe dehydration.

An appropriate oral antibiotic, guided by local resistance patterns, is given for confirmed or clinically likely bacillary dysentery — options include ciprofloxacin or, in children, an appropriate alternative such as azithromycin.

Zinc supplementation is given to children under five alongside treatment, as it shortens the illness and reduces future episodes.

Antidiarrhoeal medicines that slow gut motility are avoided, as they can worsen the illness.

Patients with severe dehydration, high fever, or complications are referred for hospital-level care.

• Drink water from safe sources, or boil or treat water before drinking.
• Wash hands with soap after using the toilet and before handling or eating food.
• Ensure proper disposal of human waste and safe sanitation.
• Wash fruits and vegetables thoroughly and cook food adequately.
• Isolate and promptly treat cases to reduce the risk of spread, particularly in schools and crowded settings.