小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 腹泻
- 腹部绞痛
- 发热
- 溶血尿毒综合征的特征
其他诊断因素
- 里急后重
- 腹痛或压痛
- 血容量不足的体征
- 肠鸣音增加
- 呕吐
- 假性脑膜炎
- 热性惊厥
- 谵妄或嗜睡
危险因素
- 暴露于被污染的水或食物，或直接粪-口接触
- 年龄＜5 岁
- 年龄＞50 岁
- 营养不良
- 卫生条件差，居住条件拥挤
- 慢性疾病或免疫受损
- 前往疫区旅行
- 男男性行为者
诊断性检查
首要检查
- 粪便显微镜检查、粪便培养和药敏试验
- 血清尿素和肌酐
- 全血细胞计数 (FBC
需考虑的检查
- 志贺氏杆菌得血清分型
- 外周血涂片
- 腹部 X 线检查
- 可屈性乙状结肠镜检查
治疗流程
疑似或确诊细菌性痢疾
撰稿人
作者
Ashley Barnabas, MRCP
Consultant Hepatologist and Gastroenterologist
St Mark's and Northwick Park Hospitals
Middlesex
UK
利益声明
AB declares that he has no competing interests.
鸣谢
Dr Ashley Barnabas would like to gratefully acknowledge Dr Satish Keshav, Dr Gehanjali D.A. Amarasinghe, and Dr Richard Pollok, the previous contributors to this topic. Unfortunately, we have been made aware that Dr Satish Keshav has passed away.
利益声明
GDAA and RP declare that they have no competing interests.
同行评议者
David Acheson, MD
Chief Medical Officer
Director of Food Safety and Security
US Food and Drug Administration
Rockville
MD
利益声明
DA declares that he has no competing interests.
Franz Allerberger, MD, MPH
Professor of Clinical Microbiology
Austrian Agency for Health and Food Safety (AGES)
Vienna
Austria
利益声明
FA declares that he has no competing interests.
鉴别诊断
- 非志贺氏杆菌细菌性腹泻
- 病毒性胃肠炎
- 寄生虫性腹泻
更多 鉴别诊断指南
- CDC 国际旅行健康信息（黄皮书） - 细菌性痢疾
- 感染性腹泻的诊断和治疗实践指南
更多 指南患者教育信息
Diarrhoea in adults
Diarrhoea in children
更多 患者教育信息
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