Dysentery is a general term for a group of diseases which trigger inflammation of the lining of the large intestines characterized by diarrhea containing blood and mucus, resulting from inflammation of the walls of the gastrointestinal tract. Dysentery may be secondary to ankylostomiasis infection, an intestinal infection from infestation with either Ancylostoma duodenale or Necator americanus hookworms.

Dynsentary is caused by bacterial, viral, protozoan or parasitic infections, commonly found where sanitation is inadequate and where food and water may become contaminated with pathogens. The two most common causes of dysentery are infection with a bacillus or bacteria of the Shigella group, and infestation by an ameba, Entamoeba histolytica. Bacillary dysentery (see Diagnostic Code: 7322) may be caused by Shigella, Salmonella, Campylobacter and Escherichia coli. Both bacillary and amebic dysentery are spread via contaminated food and water most commonly found in places with inadequate sanitation.

One of the parasites causing dysentery is ankylostomiasis, which is a hookworm infection. The parasite, ankylostomiasis, enters the body through the mouth via food or water, by human feces, and contact with infected people. Hookworm eggs, which are deposited on the soil in feces, mature into larvae capable of penetrating the skin, especially the bare skin of the feet. An infection results when a person comes in direct contact with the eggs from the contaminated soil.

The larvae pass from the skin into the venous circulation and travel to the alveolar capillaries of the lungs, to the bronchi, trachea and into the gastrointestinal tract. The larvae matures, attaches to the mucous membrane of the intestines and begin feeding on the person's blood. The adult secretes an anticoagulant, which promotes additional bleeding. Adult hookworms produce eggs that are excreted in the feces, thus perpetuating the cycle of infection. The adult hookworm may live up to ten years.

In most cases, a hookworm infection is asymptomatic. When symptoms from hookworm infections occur, they may present in any part of the body where the path of the hookworm life cycle takes place. This may include the skin, blood, lungs and eventually the intestines.

Symptoms affecting the skin may include an allergic or local irritation or an itchy rash where the worm penetrates. In the lungs, there may be asthma-like symptoms or pneumonia. Intestinal symptoms include common symptoms of dysentery, the most common of which is severe bloody diarrhea and vomiting. The diarrhea causes people suffering from dysentery to lose important salts and fluids from the body. The individual may become severely dehydrated and develop metabolic acidosis. Severe dehydration can be fatal if untreated as vital organs such as the kidneys, brain, and heart cannot function without a certain minimum of water and salt. Other common symptoms include abdominal and rectal pain, fever, weight loss and excessive gas.

Manifestations such as anemia may occur as the worms feed on the individual's blood. The loss of blood leads to a loss of iron and protein causing difficulty in breathing, pale complexion, tiredness and weakness, rapid heartbeat, generalized swelling or bloating and impotence.

Stool samples are tested for the presence of the hookworm or other bacterial, viral, protozoan or parasitic infection. A complete blood count (CBC) is done to determine if there is anemia.

Untreated dysentery can be fatal. Mebendazole and pyrantel pamoate are used to eradicate the hookworm infection. Iron supplements may be used for the anemia. Rehydration and antibiotic therapy may be necessary.

There are usually no residuals if medical regimen is followed and prevention measures are taken. However, the hookworm can live up to 10years.

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