Dysentary

[BlueBear]

had an admission today that spent the past 7 weeks in spain and on her final day there started with severe vomitting. reports occasional diarrhea, but nothing overwhelming. anyway, her admitting diagnosis was gastroenteritis r/o dysentary. anyone familiar with this? i work on an ortho/trauma floor but we wound up getting this patient anyway and we were all desperately trying to remember facts about dysentary. is it contagious? should she be on contact or airborne precautons? a private room? any help would be appreciated!

[fiestynurse]

It is highly unlikely to be dysentary. You generally see bloody diarrhea, not so much vomiting. Also, dysentary is generally found in impoverished and highly populated countries.

However, I would probably put her in isolation until you find out what's wrong with her. Person to person contact could spread whatever it is. Good Handwashing for sure! Keep us posted.

[P_RN, ADN, RN]

Pardon my French, but there are an a** load of causes for this problem.

Oh and Blue...they were ALL on the ortho floor....a nurse is a nurse after all.

Here in the good old USA (SC) we had a patient-one of our lab people actually-who had a case of Typhoid fever....big time dysentery.

Our social worker had an intestinal parasite.....big time......

One of our docs visited Bolivia...got giardiasis.....

One of our nurses did reserve training in Costa Rica....got "something" same story......

Enteric precautions/universal/standard precautions. Wash, glove, wash, wash, wash!

Oh yes I forgot about the Russian lady/also a microbiologist who brought her own microscope....who had some bug only found in the lakes in the USSR......

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera_lab_manual.htm

[fiestynurse]

I guess when I think of the word "dysentary", I think of the epidemic type dysentary that they get in third world countries. Generally, when we had someone show up in our Urgent care with n/v, mostly diarrhea, it was due to some type of food poisoning (contaminated meat, unpasteurized dairy products, and those notorious salmonella ridden eggs) or drinking bad water on a hiking or camping trip.(the dreaded giardia) Usually, it had a bacterial or parasitic origin. We ran stool cultures and treated with antibiotics. I am sure they have asked this patient about what she ate and drank when she was in Spain. Did she eat some weird food from a local street vendor? Did she drink water from a mountain stream, while hiking? Was anyone else on the trip sick?

[MollyJ]

Some people use dysentery in the specific sense and others in the more generic sense (traveler's diarrhea) but I think that you have to think of traveler's diarrhea in this scenario and I agree with enteric precautions and, of course, good handwashing.