Speelman P, McGlaughlin R, Kabir I, Butler T
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Trans R Soc Trop Med Hyg. 1987;81(4):549-51. doi: 10.1016/0035-9203(87)90402-0.
To obtain information that could assist the clinician to differentiate between shigellosis and amoebic dysentery, we compared clinical features and stool findings in 58 adult male patients in Bangladesh. Mean values indicated that patients with invasive amoebiasis were older and had a longer prehospital illness, a lower body weight, less frequent fever, a lower haematocrit and a higher white blood cell count than patients with shigellosis. The mean number of faecal leucocytes per mm3 was significantly higher in shigellosis than in amoebiasis (28,700 vs 10,300) and correlated with the estimated number of faecal leucocytes per microscopic high power field in a wet mount preparation. Patients with shigellosis more often had over 50 white blood cells per high power field. Although the mean stool pH in amoebiasis was lower than in shigellosis (6.26 vs 6.60), the difference was not statistically significant. Concentrations of stool electrolytes did not differ between the two diseases. These findings indicate that age, duration of illness, the presence of fever and the number of faecal leucocytes may help to differentiate between shigellosis and amoebic dysentery.
为获取有助于临床医生鉴别志贺氏菌病和阿米巴痢疾的信息，我们比较了孟加拉国58例成年男性患者的临床特征和粪便检查结果。均值表明，侵袭性阿米巴病患者比志贺氏菌病患者年龄更大、院前患病时间更长、体重更低、发热频率更低、血细胞比容更低且白细胞计数更高。志贺氏菌病患者每立方毫米粪便白细胞的平均数量显著高于阿米巴病患者（28,700对10,300），且与湿片制备中每高倍视野粪便白细胞的估计数量相关。志贺氏菌病患者每高倍视野白细胞超过50个的情况更为常见。尽管阿米巴病患者粪便的平均pH值低于志贺氏菌病患者（6.26对6.60），但差异无统计学意义。两种疾病的粪便电解质浓度没有差异。这些发现表明，年龄、病程、发热情况和粪便白细胞数量可能有助于鉴别志贺氏菌病和阿米巴痢疾。
