ACUTE INFLAMMATORY DIARRHOEA (DYSENTERY)

DESCRIPTION

Diarrhoea with neutrophils, blood and/or mucus. Causes include shigella,

salmonella and campylobacter.

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.

Stool culture is advised.

MEDICINE TREATMENT

Loperamide is contraindicated as it may result in toxic megacolon.

Antibiotic therapy

Consider in severe cases or significant underlying disease.

• Ciprofloxacin, oral, 500 mg 12 hourly for 3–7 days.

REFERRAL

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

Reference and further reading

Standard Treatment Guidelines and Essential Medicines List for South Africa 2012 Edition