Shigellosis, Enteric Fever and Peptic Ulcer Disease
Session 21: Shigellosis, Enteric Fever and Peptic Ulcer Disease
Total Session Time: 120 minutes
Pre-requisites
Students Learning Tasks
By the end of this session students are expected to be able to:
Describe Shigellosis, Enteric Fever and Peptic Ulcer Disease
Describe treatment, prevention and control of Shigellosis, Enteric Fever
and Peptic Ulcer Disease
Resources Needed:
SESSION OVERVIEW
|Step |Time |Activity/ |Content |
| | |Method | |
|1 |5 minutes |Presentation |Introduction, Learning Tasks |
|2 | 35 minutes|Presentation |Shigellosis |
|3 |35 minutes |Brainstorming/|Typhoid Fever |
| | |Presentation | |
|4 |35 minutes |Brainstorming/|Peptic Ulcer Disease |
| | |Presentation | |
|6 |5 minutes |Presentation |Key Points |
| 7|5 minutes |Presentation |Evaluation |
SESSION CONTENTS
STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing
STEP 2: Shigellosis (35 minutes)
o Shigellosis is an infectious disease caused by shigella (Shigella
dysenteriae)
o Most who are infected with shigella develop diarrhea, fever, and
stomach cramps starting a day or two after they are exposed to the
bacteria
o Sudden onset of severe abdominal cramping, high-grade fever,
emesis, anorexia, and large-volume watery diarrhea
o Abdominal pain, tenesmus, urgency, fecal incontinence, and small
volume of bloody, mucoid diarrhoea.
o Extra intestinal manifestations associated with S. dysenteriae may
include the following:
convulsions
anemia, thrombocytopenia, and renal failure, profound
dehydration and hypoglycemia
o Replacement of fluids and electrolytes
o Antibiotics
o Hygienic disposal of refuse
o Hygienic food handling
o Personal hygiene e.g. washing hands after using toilets and before
eating
o Washing of fruits and vegetables
STEP 3: Typhoid Fever (35 minutes)
o Typhoid fever is also known as Enteric fever
o Typhoid fever is an acute systemic disease caused by the gram-
negative bacteria Salmonella typhi.
o Salmonella paratyphi causes paratyphoid fever which has the same
features as typhoid fever.
o Typhoid infection is transmitted through ingestion of contaminated
food and water
|Activity: Brainstorming (5 minutes) |
| |
|Ask students to brainstorm on the following question: |
| |
|What are signs and symptoms observed in a patient with |
|enteric fever? |
| |
|ALLOW few students to respond? |
| |
|WRITE their responses on the flip chart/ board |
| |
|CLARIFY and SUMMARIZE by using the content below |
o The clinical manifestation and duration of illness vary markedly
from one patient to another
o The course of paratyphoid fever is shorter and less severe
compared to that of typhoid fever
o The major clinical features are:
muscle pains (myalgia)
obtundation, intestinal hemorrhage, bowel perforation, and
death
neuropsychiatric complications
o Treatment
o Prevention and control
STEP 4: Peptic Ulcer Disease (35 minutes)
o Cause
o Peptic ulcer disease is a circumscribed ulceration of the
gastrointestinal mucosa occurring in areas exposed to acid and
pepsin (lower oesophagus, stomach and duodenum) and most often
caused by Helicobacter pylori infection
o Gastro Esophageal Reflux Disease (GERD), a disorder resulting from
gastric acid and other gastric contents into the esophagus due to
incompetent barriers at the gastro esophageal junction may result
in ulceration of the lower oesophagus
o Peptic ulcer presents in many different ways
o The commonest is chronic, episodic pain present in many different
ways, and may persist for months or years.
o However, the ulcer may come to attention as an acute episode with
bleeding or perforation, with little or no previous history
o Epigastric pain is the commonest symptom of peptic and gastric
ulcer
|Activity: Brainstorming (5 minutes) |
| |
|Ask students to brainstorm on the following question: |
| |
|What are the treatment options for Peptic Ulcer Disease? |
| |
|ALLOW few students to respond? |
| |
|WRITE their responses on the flip chart/ board |
| |
|CLARIFY and SUMMARIZE by using the content below |
o Treatment goal for PUD
prevent complication
if H. pylori is not present
a triple therapy is used to eradicate the bacteria and provide
relief and healing
Amoxycillin or Azithromycin + Nitroimidazole is used.
o Discontinue NSAIDs and use paracetamol for pain control if
possible
o By using acid suppression e.g. Antacids
o Smoking cessation
o No dietary restrictions unless certain foods
o Alcohol in moderation
o Stress reduction
STEP 5: Key Points (5 minutes)
o Shigellosis is an infectious disease caused by Shigella
dysenteriae
o Most who are infected with shigella develop diarrhea, fever, and
stomach cramps starting a day or two after they are exposed to the
bacteria
o Typhoid fever is an acute systemic disease caused by the gram-
negative bacteria Salmonella typhi
o Both shigellosis and typhoid fever are transmitted through fecal-
oral route
o Peptic ulcer disease is a circumscribed ulceration of the
gastrointestinal mucosa occurring in areas exposed to acid and
pepsin (lower oesophagus, stomach and duodenum) and most often
caused by Helicobacter pylori infection
o Treatment of peptic ulcer disease should base on triple therapy
unless H. pylori is ruled out
STEP 6: Evaluation (5 minutes)
References
Hugo and Russell (2011), Pharmaceutical Microbiology 8th Edition, Willey-
Blackwel publications
Karen C. Carroll et al (2013); Jawetz, Melnick and Adelberg’s Medical
Microbiology 26th Ed. McGraw Hill Co. Inc.
Greenwood et al (2012); Medical Microbiology, 18th edition Churchill
Livingstone
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