The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
Wenyon noted a case of coccidial infection (_Isospora hominis_)
in which there was a dysenteric syndrome. There have been about
seventy cases of infection with this parasite reported, chiefly
from soldiers serving in Gallipoli. The usual opinion is that they
are nonpathogenic parasites. The oocysts are ovoid, with one end
narrowed, and measure 28 × 14 microns. There are two sporocysts,
each of which contains four sporozoites. The cyst when first passed
is unsegmented.
_Helminthic dysenteries._—1. In addition to the protozoal causes
above noted we may have dysenteric symptoms following infections with
trematodes, especially _Schistosoma mansoni_ and _S. japonicum_. In
these cases we have mucus coating the stool with more or less clotted
blood in which mucus we may find the diagnostic ova. A rather high
eosinophilia is present.
2. Infections with _Gastrodiscus hominis_ also give rise to
dysenteric manifestations.
3. A very small cestode, _Heterophyes heterophyes_, has been noted
to cause a condition suggestive of dysentery.
4. In 1902, Brumpt noted the finding of a nematode,
_Oesophagostomum brumpti_, in the large intestine of an African
native, which caused dysenteric symptoms and, more recently,
another species, _O. stephanostomum_, has been reported as causing
a fatal dysentery in a Brazilian at Manaos.
5. There have also been reported cases with dysenteric
manifestations which were apparently connected with intestinal
myiasis.
=B. Dysenteries caused by bacteria.=
1. Those caused by either the more toxic, nonacid mannite strain of
Shiga, or the less toxic, acid mannite strains of the Flexner group.
2. Morgan has reported as the cause of certain bacillary dysenteries
a bacillus known as B. Morgan No. 1. It is motile, produces indol,
and in glucose bouillon gives a very slight amount of gas. It does
not change mannite and does not produce a primary acidity in litmus
milk. This organism is a frequent cause of summer diarrhoea of
children. Flies from houses with such cases often show Morgan’s
bacillus.
Paratyphoid infections may give the clinical picture of a colitis
and such cases at times show a large amount of blood in the
dysenteric stools. Usually the symptoms are rather those of an
entero-colitis or a gastro-enteritis.
3. In Japan, dysentery-like epidemics of a very fatal disease, termed
_ekiri_, occur among young children. The organism is very motile,
producing gas and acid in glucose, but not in lactose media. It is
reported at times to show indol production. Apparently a member of
the Gärtner group.
4. Spirillar dysentery. LeDantec has reported a type of dysentery
which shows the presence of great numbers of spiral forms. These
are Gram negative and noncultivable. It is in question whether they
belong to the bacteria. There is no fever in this type of dysentery.
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