Amoebic Dysentery
Amoebic dysentery also referred to as Amebiasis is an infectious disease caused by a protozoan parasite referred to as Entamoeba histolytica, which causes both intestinal and extraintestinal infections. Some of the risk factors for amebiasis include consuming contaminated food or water, association with food handlers, whose hands are contaminated, fertilizer made of human waste, being pregnant and contact with contaminated medical devices such as colonic irrigation devices.
Amebiasis occurs worldwide, however it is most common in tropical areas that have crowded living conditions and poor sanitation. Africa, Mexico, parts of South America and India have major prevalence of amebiasis.
Common Symptoms
Only about 10-20% of infected individuals show symptoms and signs. The symptoms and signs include:
- Fatigue
- Fever and chills
- Weight loss
- Flatulence
- Intermittent constipation
- Loose stool
- Mild abdominal cramping
- Frequent watery or bloody stools with severe abdominal cramping
- Appetite loss
Bacillary Dysentery
Bacillary dysentery is an intestinal infection caused by a group of Shigella bacteria which can be found in the human gut. Bacillary dysentery is transmitted directly by physical contact with the faecal material of a patient or carrier including (during sexual contact) or indirectly through consumption of contaminated food and water.
Infection by Shigella may be asymptomatic or only cause mild illness. For patients who develop bacillary dysentery, symptoms may include:
- Acute onset of fever
- Diarrhea with abdominal cramps
- Nausea and vomiting
- The stool may contain blood and mucus
Complications of bacillary dysentery may include toxic dilation of large intestine and acute kidney disease. The best way to prevent incidences of both bacillary and amoebic dysentery is to ensure frequent hand hygiene, especially before handling food or eating and after using toilet or handling faecal matter.
Also Read: Difference Between Diarrhea And Dysentery
Difference Between Amoebic Dysentery And Bacillary Dysentery In Tabular Form
Difference In Pathology
BASIS OF COMPARISON | AMOEBIC DYSENTERY | BACILLARY DYSENTERY |
Causative Agent | Entomoeba histolytica. | Shigella species Enterohemorrhagic E. coli Vibrio parahemolyticus Campylobacter jejuni |
Nature Of Lesion | Necrotic due to proteolytic ferment. | Suppurative due to diffusible toxins. |
Depth Of Ulcer | Usually Deep. | Shallow |
Type Of Necrosis (Cellular Level) | Pyknotic (pyknotic body and mouse eaten cells). | Karyolysis (ghost cell and ring nucleus). |
Liver Abscess | Common. | Rare. |
Cellular Response | Mononuclear | Polymorphonuclear. |
Margin of Ulcer | Ragged and undermined. | Uniform, clear-cut (sharp) |
Difference In Clinical Features
BASIS OF COMPARISON | AMOEBIC DYSENTERY | BACILLARY DYSENTERY |
Onset | Slow | Acute |
Fever | Absent | Present |
Abdominal Tenderness | Localized | Generalized |
Tenesmus | Absent | Present |
Difference In Macroscopic Features Of Stool
BASIS OF COMPARISON | AMOEBIC DYSENTERY | BACILLARY DYSENTERY |
Number of Motions | 6-8 motions in 24 hours | Over 10 in 24 hours. |
Amount | Relatively copious | Small amount |
Odor | Offensive (fishy odor) | Odorless |
Color | Dark red (altered blood) | Bright red (fresh blood) |
Nature | Blood and mucus mixed with faeces. | Blood and mucus, mainly watery. |
Reaction | Acidic | Alkaline (for fresh blood) |
Consistency | Liquid or formed, mucus not adherent to the container. | Viscid, mucus adherent to the container. |
Difference In Microscopic Features Of Stool
BASIS OF COMPARISON | AMOEBIC DYSENTERY | BACILLARY DYSENTERY |
RBCs | In clumps | Discrete, sometimes in clumps due to rouleaux formation. |
Macroscopic pathology | Passage of loose stool with mucus and little blood. | Small, blood and mucus present but no faeces. |
Pus Cells | Scanty | Numerous |
Macrophages | Few | Numerous, many of them contain RBCs hence may be mistaken for E. histolytica. |
Cellularity | Poor | High |
Ghost Cell (Swollen epithelial cells) | Nil | Numerous |
Eosinophils | Present | Scarce |
Pyknotic Nuclear Residues (Nuclear remains of tissue cells and leukocytes) | present | Absent |
Charcot-Leyden (C-L) crystals | Present | Absent |
Parasites Seen | Trophozoites of E. histolytica | Nil |
Bacteria Seen | Numerous motile E.coli and other Enterobacteria. | Scanty, non-motile shigella group or klebsiella. |
Culture (Growth On MacConkey Agar) | Various intestinal flora may grow. | Pure growth of shigella species may be seen. |
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