Dysentery (Acute Inflammatory Diarrhoea)

Description

General Measures

Medicine Treatment

Referral

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ICD-10 code: A02.0/A02.9/A03.0-3/A03.8-9/A04.2/A04.5/A04.8-9

DESCRIPTION

Diarrhoea with neutrophils, blood and/or mucus.

GENERAL MEASURES

• Rehydration is the cornerstone of management. This should be done with oral rehydration solution (ORS) unless the patient is vomiting or profoundly dehydrated.
• Perform a stool culture.

MEDICINE TREATMENT

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CAUTION
Loperamide is contraindicated as it may result in toxic megacolon.

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Antibiotic therapy

Consider in patients with signs of sepsis and severe cases or significant underlying disease:

• Ceftriaxone, IV 1 g daily.

Switch antibiotic when clinically appropriate:

• Ciprofloxacin, oral,  500 mg 12 hourly, ideally based on culture and sensitivity if available.

For uncomplicated dysentry in patients with no co-morbidity:

• Ciprofloxacin, oral, 500 mg 12 hourly for 3 days.
  • Extend treatment duration to 7 days in patients with significant co-morbidity, e.g. immunocompromised patients.

REFERRAL

Persistent diarrhoea with blood and mucus for longer than 2 weeks.

Click here for the pdf.

Click here for the NEMLC Recommendations for medicine treatement (2020-4 review cycle).

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Standard Treatment Guidelines And Essential Medicines List For South Africa, Adult Hospital level, 2020-4_Version 1_July 2024

Chapter 1: Alimentary tract; 1.3 Diarrhoea; 1.3.2 Dysentery (Acute Inflammatory Diarrhoea)