A03.0-3/A03.8-9/A41.0-5/A41.8-9
DESCRIPTION
Diarrhoea with neutrophils, blood and/or mucus.
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 patients with signs of sepsis and severe cases or significant underlying disease:
- Ceftriaxone, IV 1g daily.
- Switch to oral therapy when clinically appropriate i.e. ciprofloxacin 500mg 12 hourly.
For uncomplicated dysentry in patients with no co-morbidity:
- Ciprofloxacin, oral, 500 mg 12 hourly for 3 days.
For uncomplicated dysentry in patients with significant co-morbidity e.g. immunocompromised patients:
- Ciprofloxacin, oral, 500 mg 12 hourly for 7 days.
REFERRAL
Persistent diarrhoea with blood and mucus for longer than 2 weeks.