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Amoebic dysentery vs. Bacillary dysentery

Amoebic dysentery vs. Bacillary dysentery

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Acute diarrhea is categorized as noninflammatory (watery, non-bloody) or inflammatory (bloody). The term dysentery refers to bloody diarrhea.

Bloody diarrhea caused by Shigella is often called bacillary dysentery. Other bacterial causes of dysentery are, Vibrio parahaemolyticus, Enteroinvasive E.coli (EIEC), Enterohemorrhagic E.coli (EHEC), Campylobacter sps, and Salmonella sps. Bloody mucous containing diarrhea caused by bacterial pathogens is often accompanied by inflammatory cells (neutrophils). Other symptoms include fever, abdominal cramping, tenesmus, and pain in defecation.

Amoebic dysentery (also known as amoebiasis) is caused by an invasive protozoan parasite, Entamoeba histolytica.

Difference Between Amoebic Dysentery and Bacillary Dysentery

Character

Amoebic dysentery

Bacillary dysentery

Macroscopic

Number

6-8 motions a day

Over 10 motions a day

Amount (Volume)

Relatively copious

Small amount

Appearance and Amount

Blood mucus, semi formed

Blood mucus, mainly watery

Odour

Offensive (fishy odour)

Odourless

Colour

Dark red (altered blood)

Bright red (fresh blood)

Reaction

Acidic

Alkaline

Consistency

Not adherent to the container

Adherent to the container

Microscopic

RBCs

In clumps

Discrete, sometimes in clumps due to rouleaux formation

Pus Cells

Few

Numerous

Macrophages

Few

Numerous, many of them contain RBCs hence may be mistaken for E. histolytica

Eosinophils

Present

Scarce

Charcot-Leyden (C-L) crystals*

Present

Absent

Pyknotic bodies**

Present

Absent

Ghost Cells***

Absent

Present

Parasites Seen

Trophozoites of E. histolytica

Absent

Bacteria Seen

Many motile bacteria

Scanty, nonmotile  (Shigella is nonmotile bacteria)

Culture

Growth on MacConkey Agar

Various intestinal flora may grow

Pure growth of Shigella spp. may be seen

Further notes:

Charcot Leyden Crystals - Charcot Leyden CrystalsFigure: Charcot Leyden Crystals

  • Charcot-Leyden crystals are hexagonal bipyramidal structures, formed from the breakdown of eosinophils and may be seen in the stool or sputum of patients withparasitic diseases*.
  • **Pyknotic bodies are the nuclear remains of tissue cells and leukocytes, they may present in the stools of persons suffering from amoebiasis.
  • ***Ghost cell is a swollen/enlarged epithelial cell with only cytoplasmic outline but without a nucleus.

References

  1. Manson-Bahr, P. E., & Ormerod, W. E. (1971). Amoebic and bacillary dysentery and the enteric fevers. The Practitioner, 207(238), 154–163.
  2. Cook G. C. (1977). Dysentery-bacillary and amoebic. Nursing mirror and midwives journal, 144(12), 54–57.
  3. Dans, L. F., & Martínez, E. G. (2007). Amoebic dysentery. BMJ clinical evidence, 2007, 0918.
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