Tropical Travel Trouble 004 Bloody Diarrhoea

LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 004 A medical student who has just returned from their elective in Nepal presents with 1 week of bloody diarrhoea. He has been in the lowlands and stayed with a family in the local village he was helping at. It started three days before he left and he decided to get home on the plane in the hope it would settle. He is now opening his bowels 10x a day with associated cramps, fevers and has started feeling dizzy. Questions: Q1. What is dysentery and what is your differential? Answer and interpretation expand(document.getElementById('ddet1062080037'));expand(document.getElementById('ddetlink1062080037')) Dysentery is simply diarrhoea with blood – it is usually associated with fever but this is not always the case. Sir William Osler described dysentery as “One of the four great epidemic diseases of the world”. He further stated “In the tropics it destroys more life than cholera, and it has been more fatal to armies than powder and shot.” Differentials include: Bacterial Gram positive – Clostridium Difficile Gram negative – Shigellosis, Enterohaemorrhagic E.coli, Salmonella, Yersinia enterocolitica Protozoa – Entamoeba histolytica, Balantidium coli Helminths – Schistoma (S. mansion or S. japonicum), Ascariasis, Trichuriasis Non-infectious – inflammat...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine amoebic dysentery bacillary dysentery e.histolytica entamoeba histolytica shigellosis Source Type: blogs