What are the symptoms of bacterial diarrhea?

Bacterial diarrhea is a type of diarrhea, which can be divided into acute bacillary dysentery and chronic bacillary dysentery. In the case of acute bacillary dysentery, the patient will experience nausea, vomiting, abdominal pain, bloody stools, high fever, etc.; in the case of chronic bacillary dysentery, there are no special symptoms, but if it is not treated for a long time, it will cause purulent stools, etc.

1. Acute bacillary dysentery

There are mainly systemic poisoning symptoms and digestive tract symptoms, which can be divided into four types:

(1) Common type (typical): acute onset, moderate toxemia, chills, fever up to 39°C, fatigue, loss of appetite, nausea, vomiting, abdominal pain, diarrhea, and tenesmus. The patient first has watery stools, which turn into bloody stools after 1 to 2 days. The patient has dozens of bowel movements a day, with small amounts of stool and no significant water loss. It is often accompanied by hyperactive bowel sounds and left lower abdominal tenderness. The general course of the disease is 10 to 14 days.

(2) Mild (atypical) systemic poisoning symptoms, abdominal pain, tenesmus, and tenderness in the left lower abdomen are not obvious. There may be low fever, mushy or watery stools mixed with a small amount of mucus, no pus or blood, and diarrhea frequency is generally less than 10 times a day. Microscopic examination of stool shows red and white blood cells, and culture shows the growth of Shigella dysenteriae, which can be used to distinguish it from acute enteritis. The general course of the disease is 3 to 6 days.

(3) Severe case: More common in elderly, weak or malnourished patients. There are severe systemic poisoning symptoms and intestinal symptoms. The disease has an acute onset, high fever, nausea, vomiting, severe abdominal pain and tenderness in the abdomen (especially in the left lower abdomen), obvious tenesmus, bloody stools, frequent bowel movements, and even incontinence. The disease progresses rapidly, with obvious water loss, cold limbs, extreme exhaustion, and easy occurrence of shock.

(4) Toxic type. This type is more common in children aged 2 to 7 years old with good physical fitness. The onset is acute, with obvious symptoms of systemic poisoning, high fever reaching over 40°C, patients with lethargy, pale complexion, cold limbs, weak breathing, skin patterns, repeated convulsions, drowsiness, and even coma, while the intestinal inflammatory reaction is extremely mild. According to clinical manifestations, it can be divided into shock type (with infectious shock as the main manifestation), brain type (with central nervous system symptoms as the main manifestation) and mixed type (with manifestations of both types, which is the most dangerous). This is due to the action of Shigella dysenteriae endotoxin and may be related to the specific constitution of some children.

2. Chronic bacillary dysentery

Patients with bacillary dysentery may have repeated attacks or the disease may persist for more than 2 months, which may be related to improper treatment in the acute phase or the type of pathogenic bacteria (Flexerella infection can easily become chronic). It may also be related to poor general condition or chronic diseases in the local gastrointestinal tract. The main pathological changes are colon ulcerative lesions. Polyps may form at the edges of the ulcers. Scars are left after the ulcers heal, leading to intestinal stenosis. The classification is as follows:

(1) Chronic latent type. The patient has a history of bacillary dysentery but no clinical symptoms. Stool culture is positive for pathogens, and sigmoidoscopy may reveal manifestations of bacillary dysentery such as mucosal inflammation or ulcers.

(2) Chronic protracted type. Patients have a history of acute bacillary dysentery, which persists for a long time, with abdominal distension or long-term diarrhea, mucus, pus and blood in the stool, and long-term intermittent bacterial excretion, which is an important source of infection.

(3) Acute attack of chronic type. The patient has a history of acute bacillary dysentery. The symptoms are no longer obvious after the acute phase. Factors such as cold and improper diet cause the symptoms to reappear, but they are milder than those in the acute phase.