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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following a nationwide outbreak of Shigella dysentery type 1 and the recognition of Shigella isolates resistant to ampicillin, the drug of choice, we conducted a clinical trial to compare the efficacy of ampicillin v. trimethoprim-sulphamethoxazole for the treatment of Shigella dysentery. Patients with symptoms of dysentery and no other complicating illness were randomized into one of two treatment groups. Patients in the two groups were comparable at the time of hospital admission with regard to age, sex, presenting complaints and Shigella strains. They responded well with both regimens and there was no significant difference in the mean time until stool became culture negative (1.4 days), temperatures returned to normal (2.7 days) and faecal leucocytes disappeared (3.0 days); abdominal pain, tenesmus and stool blood and mucus improved significantly more rapidly with trimethoprim-sulphamethoxazole than with ampicillin. There was no evidence of toxicity with either drug. While both drugs are effective for the treatment of Shigella dysentery, trimethoprim-sulphamethoxazole was considered to be superior.
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PMID:Clinical trial of ampicillin v. trimethoprim-sulphamethoxazole in the treatment of Shigella dysentery. 675 58

The epidemiologic and clinical characteristics of 412 patients infected with Shigella from a systematic sample of approximately 100,000 patients attending Dacca Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh, between December 1, 1979, and November 30, 1980, were reviewed. Shigella was isolated from 11.6% of the 3,550 patients in the sample and was the second most common isolate in patients over two years old. Two clinical presentations of shigellosis were found: (I) watery diarrhea occurring in younger children and associated with a shorter duration of illness and with more vomiting and dehydration and (2) dysentery with stool blood and abdominal pain. These different presentations may reflect two mechanisms in the pathogenesis of shigellosis or different stages of the disease. The most useful signs and symptoms for the diagnosis of shigellosis were stool with blood and abdominal pain in all patients and the absence of watery diarrhea and vomiting in patients over one year old. Simple visual inspection of stool for blood correctly identified 44% of all patients infected with Shigella.
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PMID:Epidemiologic and clinical features of patients infected with Shigella who attended a diarrheal disease hospital in Bangladesh. 710 70

In Eseka and Edea bilharziasis caused by S. intercalatum is transmitted by B. forskali, the only intermediate host of human schistosomes found in the area. The prevalence of the disease is obtained by calculating the percentage of inhabitants voiding eggs in their stools in the districts of the towns located in the neighbourhood of Bulinus-containing streams and ponds. The prevalence is low, 5,6% in Eseka and 4,9% in Edea. The size and the number of waterbodies where transmission occurs is small. Rectoscopy showed that rectal and sigmoid lesions are frequently seen. Clinical manifestations are abdominal pain, diarrhoea, dysentery, tenesmus, appearance of blood in the stools. Hepatomegaly and splenomegaly occur sometimes. A single dose of 2-cyclohexylcarbonyl-1,2,3,6,7,11b-hexahydro-4H-pyrazino[2,1-a] isoquinolin-4-one (praziquantel, EMBAY 8440, Biltricide) is effective in the treatment of the disease.
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PMID:[Epidemiological study of foci of S. intercalatum schistosomiasis in Eseka and Edea (Cameroon). Effects of treatment with praziquantel]. 719 50

The role played by Campylobacter jejuni in the origin of infantile bacterial gastroenteritis is important. Diarrhea, often bloody, is dysentery-like. Fever, abdominal pain and vomiting are rarely lacking. Dehydration is exceptional. Spontaneous recovery occurs in about ten days. Campylobacter jejuni is a Gram-negative, oxidase-positive, microaerophilic bacillus. The often typical results of direct morphological examination of the stools, special culture and isolation techniques, the erythromycine sensitivity of the germ, clearly define campylobacteriosis. Its epidemiology is still being investigated.
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PMID:[Infantile digestive campylobacteriosis. Two case studies (author's transl)]. 739 42

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men, were of similar age and in similar nutritional condition and had been infected simultaneously at the same transmission site. Most (85%) showed some gastro-intestinal sign or symptom, generally of light or moderate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain, 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon palpation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manifestation. There was no apparent association between any clinical manifestation and peripheral-blood eosinophil counts or titres of IgE specific for Schistosoma mansoni (evaluated by the area of immediate intradermal reaction to injected adult worm antigen). The absence of association between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm burden, such as host reactivity, constitute important pathogenetic elements in the initial phase of schistosomiasis mansoni.
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PMID:Gastro-intestinal manifestations of the initial phase of schistosomiasis mansoni. 766 18

An epidemic of Shigella dysenteriae type 1 infections has affected Africa since 1979. Reported dysentery cases increase sharply in Burundi during September through December. Of stool samples from 189 patients reporting bloody diarrhea in November 1990, a pathogen was identified in 123 (65%). The pathogen was S. dysenteriae type 1 in 82 (67%). All S. dysenteriae type 1 isolates were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Thirty-two specimens (26%) yielded other Shigella species. Patients with S. dysenteriae type 1 were more likely than those with other Shigella infections to have abdominal pain, "lots of blood" in the stool, blood in the stool specimen examined by the interviewer, recent contact with a person with dysentery, or recent antimicrobial treatment. Thus, the seasonal increase in dysentery was due largely to multidrug-resistant S. dysenteriae type 1, clinical and epidemiologic features may predict such infection, and efforts to control this epidemic must focus on preventing transmission.
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PMID:Epidemic Shigella dysenteriae type 1 in Burundi: panresistance and implications for prevention. 816 88

Stool samples of 1488 children suffering from acute diarrhoea were studied for bacterial culture and sensitivity. Shigella culture was positive in 143 (10 per cent) children and 53 hospitalized children could be studied in detail. Thirty-six (68 per cent) children were under 2 years of age and peak prevalence was observed in summer months. Fever and diarrhoea were universal features; 96 per cent had blood and mucus in the stools, but 32 per cent started with watery diarrhoea lasting 1-3 days followed by dysentery. Two cases (4 per cent) had watery diarrhoea. Abdominal pain dehydration, and malnutrition were present in more than two-thirds of the cases. Central nervous systemic (CNS) manifestations, renal failure, respiratory manifestations, and subacute intestinal obstruction were seen in 45, 25, 17, and 5 per cent of cases, respectively. Shigella dysenteriae was the commonest organism grown in 57 per cent, followed by Shigella flexneri in 36 per cent, Shigella boydii in 4 per cent, and Shigella sonnei in 4 per cent cases. In the majority, the organisms were sensitive to neomycin (83 per cent), furazolidine (86 per cent), and cephaloridine (87 per cent), whereas Shigella strains were resistant to tetracycline in 93 per cent, ampicillin in 83 per cent, chloramphenicol in 91 per cent and cotrimoxazole in 66 per cent cases. Proctosigmoidoscopy was useful in defining the nature of mucosal lesion, to collect swabs for culture and biopsy specimen for histopathology. Four (8 per cent) cases had pseudomembrane and in two cases Clostridium difficile could be identified. Eight (15 per cent) cases died and two of them had shigellaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Shigellosis in children from north India: a clinicopathological study. 853 Dec 65

A study was carried out in 3 villages near Calcutta, India, having a population of 5464, between August 1992 and December 1994. A cohort of rural children below 4 years of age was prospectively observed to determine the clinico-epidemiological aspects of mucoid diarrhoea and examine propensity to invasiveness. Overall, the incidence of diarrhoea was 1.7 episodes/child/year, and that of mucoid and bloody dysentery was 0.8 and 0.2 episodes/child/year, respectively. Children aged 6-11 months had a higher incidence of mucoid diarrhoea (1.3 episodes/child/year) and the peak season occurred in June and July. Multivariate analysis using logistic regression showed that mucoid diarrhoea and bloody dysentery were closely similar in both clinical and laboratory findings, including raised faecal leucocyte count (> 10/high power microscope field [hpf]). However, abdominal pain occurred more frequently in bloody dysentery than in mucoid diarrhoea. Faecal leucocyte count (> 10/hpf) can therefore be used as an indicator for invasiveness of mucoid diarrhoea at the community level.
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PMID:Epidemiological and clinical profiles of acute invasive diarrhoea with special reference to mucoid episodes: a rural community-based longitudinal study. 894 69

A dysentery outbreak in the Central African Republic village of Zemio was diagnosed as "Shigella flexneri" by the Pasteur Institute in Bangui (IPB) in February 1996; 2 months later there was an outbreak of hemorrhagic colitis. 108 patients presented with bloody diarrhea; cramping abdominal pain, fever, nausea, and vomiting were uncommon. The illness lasted between 5 days and 3 weeks (average, 8 days). Antibiotics were ineffective. Four patients died and several developed hemolytic-uremic syndrome. Stool cultures done at IPB tested negative. PCR was used to detect enterohemorrhagic Shiga-like toxin (SLT) 1 and 2, the invasivity gene ipaH, and the attaching and effacing gene eaeA. DNA fragments of 130 and 494 nucleotides corresponding to amplified SLT1 and eaeA were found in 80% of the specimens tested. No amplification was obtained for SLT2 or for ipaH in specimens collected during the second epidemic. These results suggest the presence of enterohemorrhagic Escherichia coli and the absence of Shigella. The number of reported cases of acute bloody diarrhea in infants and adults in Bangui has increased since 1996. E. coli O157:H7 was isolated from two fatal adult cases. Smoked zebu meat was suspected in several hospital cases (bloody diarrhea, hemolytic anemia, and renal insufficiency) in which non-fermenting sorbitol E. coli O157:H7 was not isolated. In two cases of acute diarrhea, other serotypes of E. coli were indicated by retrospective PCR on stools which were positive for SLT1 and for eaeA and negative for invasivity. A study was conducted in Bangui on 290 cases (33 with bloody diarrhea) and 140 controls. Patients were not paired because of civil unrest in the city. The questionnaire included demographic and socioeconomic characteristics, environmental factors, and habitual food consumption. The major contributing factor was consumption of locally made meat pies (kanda), which were made with smoked zebu meat. Kanda is stored at ambient temperature, often for days, before it is sold in markets or along roads. Before 1996, E. coli was not reported as a cause of bloody diarrhea in the Central African Republic.
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PMID:Enterohaemorrhagic Escherichia coli in Central African Republic. 918 91

A 21-year-old female underwent allogeneic bone marrow transplantation (ABMT) from her HLA matched brother for chronic myeloid leukaemia in the chronic phase. Four weeks post transplant she developed tenesmus, mucoid stool mixed with blood and lower abdominal pain. This rapidly progressed to greenish watery diarrhoea with flakes of mucous membrane floating in it, conforming to the classical clinical description of acute GVHD of the bowel. Stool microscopy showed profuse numbers of Blastocystis hominis, a parasite with doubtful pathogenicity in an immunocompetent host. In the present case the parasite played a pathogenic role as evidenced by the profuse number in the stool sample, focal neutrophil infiltration of the rectal mucosa, initial presentation of the patient with dysentery, and requirement for prolonged metronidazole therapy to eradicate the parasite and cure the diarrhoea. She also had grade I GVHD of the liver and skin. In developing tropical countries, hitherto unreported parasitic infestations may complicate the picture of acute GVHD.
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PMID:Acute GVHD involving the gastrointestinal tract and infestation with Blastocystis hominis in a patient with chronic myeloid leukaemia following allogeneic bone marrow transplantation. 987 76


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