Dysentery natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Natural History

Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal.

Complications

• Shock
• Delirium
• Hemolytic uremic syndrome: EHECs and shigella that induce bloody diarrhea can lead to HUS. The clinical manifestations of postdiarrheal HUS include acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. The verocytotoxin (shiga-like toxin) can directly damage renal and endothelial cells. Thrombocytopenia occurs as platelets are consumed by clotting. Hemolytic anemia results from intravascular fibrin deposition, increased fragility of red blood cells, and fragmentation.
• Thrombotic thrombocytopenic purpura
• Reactive arthritis

Prognosis

With correct treatment, most cases of amoebic and bacterial dysentery subside within ten days, and most individuals will achieve a full recovery within two to four weeks after beginning proper treatment. If the disease is left untreated, the prognosis varies with the immune status of the individual patient and the severity of disease. Extreme dehydration can prolong recovery and significantly raises the risk for serious complications.