Bacteria Ruhr
the bacteria Ruhr (syn.: ) Failure illness released by Shigellen, a type of bacteria , designates ski gel lots , Shigellendysenterie, Shigellenruhr. The bacteria Ruhr is released to separate from the amoeba Ruhr, by the parasite Entamoeba histolytica. An obligation to register exists with suspicion, illness and death.
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symptoms and complaints
the bacteria Ruhr has one incubation period of 2-7 days. The illness begins with kollikartigen belly pain and Diarrhö. It comes to frequent emptying of chair, which can be painful. After some days steps i.d.R. the recovery. The large liquid and Elekrolytverlust represent the largest danger, by which it can come to kidney failure, cycle collapse, cramps and coma. According to kind of the chair one differentiates the white and the red Ruhr. With the white Ruhr the chair is slimily and brightly, with the red Ruhr bloodily. As disease sequence it can come to the rider syndrome. After endured illness separate the person still approx. 4 weeks exciters out.
causes
the cause is an infection with the following kinds of bacteria:
- Shigella dysenteriae (the Tropics/subtropics): both a Endotoxin , which lead to large intestine ulcers, and a Exotoxin ( Shiga Toxin) forms, which lead to strong, also bloody falling through and cycle complaints. Lethality is with 60%.
- Shigella boydii (India, North Africa)
- Shigella flexneri (more rarely, less dramatically, eastern countries as well as the USA)
- Shigella sonnei (Western Europe, relatively harmless)
complications
with heavy processes it can come to complications, as for instance intestine bleedings, intestine perforations, loss of water and salts (of electrolytes) as well as the reactive Arthritis.
spreading
the bacteria Ruhr is an illness of the times of distress, therefore it arises mainly with a weakened immune defense . Today's cases in Western Europe emerge accordingly usually in emergency accomodation. Humans are exciter reservoir.
The infection been made fäkal orally, in particular by infected food or drinking water. An infection dose of under 100 bacteria is sufficient. Contrary to the similar Salmonellen Shigellen are acid stable, in the stomach are not thus killed.
Vorbeugung and treatment
the fundamental Vorbeugung are hygiene measures as for instance cleanliness during the drinking water and food preparation, regular hand disinfection and company potash removal.
The diagnostics is placed on the basis the clinical symptomatology. The exciter is proven by means of a reduction from the final intestine.
The therapy consists of an improvement of the immune defense of the patient, replacement of water and electrolytes as well as antibiotics such as Chinolone or ampicillin intravenously. There some Shigellen by R-Plasmide are multi-resistant, are necessary a possible correction of the antibiotics after anti-bio gram. With cramp-like belly pain the gift of a spasmolytic can be meaningful such as n-butyl scopolamine. Obstipierende means such as Loperamid suppress fall through, retard however the elimination of the exciters from the body, are therefore at the most at short notice to be used.
sources
- Herold: Internal medicine, 2001
