Paper II
Question
Differences between bacillary and amoebic dysentery
Answer
| Feature | Bacillary dysentery (Shigella) | Amoebic dysentery (Entamoeba histolytica) |
|---|---|---|
| Onset | Sudden/acute | Gradual |
| Fever | Often present, can be high | Usually absent or low-grade |
| Stool character | Small volume, frequent, blood/mucus visible | Large volume, foul-smelling, “anchovy sauce”-like |
| Tenesmus | Prominent | Less prominent |
| Microscopy | Numerous faecal leukocytes (pus cells) | Trophozoites with ingested RBCs; few faecal leukocytes |
| Mucosal ulceration | Superficial, diffuse | Flask-shaped ulcers (narrow neck, broad base) |
| Extraintestinal spread | Rare | Can spread to liver (amoebic liver abscess) |
| Treatment | Antibiotics (ciprofloxacin, azithromycin) | Metronidazole plus luminal agent |