4. There are also dysenteric manifestations noted in the terminal stages of kala-azar (Leishmania donovani) and in algid pernicious malaria (Plasmodium falciparum). These conditions are taken up under the diseases kala-azar and malaria.
Wenyon noted a case of coccidial infection (Isospora hominis) in which there was a dysenteric syndrome. There have been about seventy cases of infection with this parasite reported, chiefly from soldiers serving in Gallipoli. The usual opinion is that they are nonpathogenic parasites. The oocysts are ovoid, with one end narrowed, and measure 28 × 14 microns. There are two sporocysts, each of which contains four sporozoites. The cyst when first passed is unsegmented.
Helminthic dysenteries.—1. In addition to the protozoal causes above noted we may have dysenteric symptoms following infections with trematodes, especially Schistosoma mansoni and S. japonicum. In these cases we have mucus coating the stool with more or less clotted blood in which mucus we may find the diagnostic ova. A rather high eosinophilia is present.
2. Infections with Gastrodiscus hominis also give rise to dysenteric manifestations.
3. A very small cestode, Heterophyes heterophyes, has been noted to cause a condition suggestive of dysentery.
4. In 1902, Brumpt noted the finding of a nematode, Oesophagostomum brumpti, in the large intestine of an African native, which caused dysenteric symptoms and, more recently, another species, O. stephanostomum, has been reported as causing a fatal dysentery in a Brazilian at Manaos.
5. There have also been reported cases with dysenteric manifestations which were apparently connected with intestinal myiasis.
B. Dysenteries caused by bacteria.
1. Those caused by either the more toxic, nonacid mannite strain of Shiga, or the less toxic, acid mannite strains of the Flexner group.