{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.dysentery","code":"thing-q129279","url":"https://ver.cy/models/thing/q129279/","name":"dysentery","alternateNames":["protozoal dysentery","dysentercic syndrome","bacillary dysentery"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Information and virtual systems","entryKind":"thing","plane":"INF","domain":["INF.KNW"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Dysentery is inflammation of the intestine causing diarrhoea with visible blood, often accompanied by frequent small-volume stools, mucus, tenesmus, cramping and fever; infectious causes include Shigella spp., Entamoeba histolytica, Campylobacter and certain Escherichia coli, and the inflammation can result from mucosal invasion or toxin-mediated injury, so invasion is not required.","purpose":"Enable an AI agent to recognise a dysentery episode, assess its course and urgency, and support evidence-based clinical and transmission-control decisions.","scope":{"in":["Evidence of diarrhoea with visible blood and the definition used to classify the episode","Onset, stool pattern, associated symptoms and changes over time","Hydration, systemic illness and factors affecting clinical urgency","Evidence supporting infectious causes or alternative explanations","Episode-specific treatment decisions, response and transmission precautions"],"out":["The person's complete longitudinal health record","Pathogen taxonomy and organism biology independent of this episode","Full models of shigellosis, amebiasis or other underlying diseases","Independent models of inflammatory bowel disease and gastrointestinal bleeding","Drug catalogues, prescribing protocols and antimicrobial surveillance systems","Outbreak management and water or sanitation infrastructure"],"boundaries":[]},"distinguishingFeatures":["Establish diarrhoea with visible red blood in loose or watery stool; mucus alone or an occult-blood result does not establish the WHO operational definition. [WHO dysentery definition](https://www.emro.who.int/health-topics/dysentery/)","Distinguish blood accompanying diarrhoeal stool from isolated rectal bleeding, blood only on wiping or an uncertain report of red stool.","Keep syndrome recognition separate from identification of Shigella: shigellosis can produce watery, bloody or prolonged diarrhoea. [CDC clinical overview](https://www.cdc.gov/shigella/hcp/clinical-overview/index.html)","Do not equate dysentery with amebiasis: amebic dysentery is one presentation, and laboratory identification must distinguish E. histolytica from similar organisms. [CDC amebiasis overview](https://www.cdc.gov/amebiasis/about/index.html)","Record whether a noninfectious explanation remains plausible instead of treating visible blood as proof of an infectious cause."],"structure":{"bundles":[{"id":"bloody-diarrhoea-recognition","name":"Bloody diarrhoea recognition","description":"Establish whether the observed episode warrants the dysentery label.","layers":[{"id":"defining-stool-observations","name":"Defining stool observations","description":"Record the diarrhoeal pattern and evidence of visible blood.","findings":[{"id":"diarrhoea-with-visible-blood","name":"Diarrhoea with visible blood","description":"Retain stool consistency, change from baseline and blood observations as distinct evidence supporting classification.","questions":[{"text":"Were loose or watery stools and visible blood observed within the same episode?","id":"diarrhoea-with-visible-blood-q01","kind":"definition"},{"text":"Who observed the stool, when, and was the account direct or reported?","id":"diarrhoea-with-visible-blood-q02","kind":"provenance"},{"text":"How did stool frequency and consistency differ from the person's usual pattern?","id":"diarrhoea-with-visible-blood-q03","kind":"measurement"}]}]},{"id":"classification-boundaries","name":"Classification boundaries","description":"Resolve ambiguous bleeding descriptions and competing uses of the term dysentery.","findings":[{"id":"syndrome-definition-and-mimics","name":"Syndrome definition and mimics","description":"Attach the classification to an explicit definition and preserve observations that may instead indicate another bleeding presentation.","questions":[{"text":"Which clinical or surveillance definition supports the dysentery label?","id":"syndrome-definition-and-mimics-q01","kind":"definition"},{"text":"Could the report represent isolated rectal bleeding, stool discoloration or occult blood without visible bloody diarrhoea?","id":"syndrome-definition-and-mimics-q02","kind":"boundary"}]}]}]},{"id":"cause-and-diagnostic-evidence","name":"Cause and diagnostic evidence","description":"Separate possible causes from supported attribution.","layers":[{"id":"etiological-assessment","name":"Etiological assessment","description":"Capture candidate infectious causes and competing noninfectious explanations.","findings":[{"id":"supported-cause-attribution","name":"Supported cause attribution","description":"Record each causal hypothesis, its supporting evidence and its unresolved alternatives without requiring a single premature diagnosis.","questions":[{"text":"Which findings support Shigella, E. histolytica, another infectious cause or a noninfectious explanation?","id":"supported-cause-attribution-q01","kind":"provenance"},{"text":"What evidence would change or overturn the current attribution?","id":"supported-cause-attribution-q02","kind":"boundary"}]}]},{"id":"stool-test-interpretation","name":"Stool test interpretation","description":"Relate laboratory evidence to the sampled episode and the limits of the method.","findings":[{"id":"specimen-result-and-limitations","name":"Specimen result and limitations","description":"Keep collection timing, prior treatment, organism identification and available susceptibility information together.","questions":[{"text":"Which specimen and method produced the result, and when was it collected relative to symptoms and treatment?","id":"specimen-result-and-limitations-q01","kind":"provenance"},{"text":"Does the method distinguish the suspected pathogen from similar organisms or leave clinically relevant uncertainty?","id":"specimen-result-and-limitations-q02","kind":"boundary"},{"text":"What additional testing or susceptibility evidence does the responsible clinician need before acting?","id":"specimen-result-and-limitations-q03","kind":"action"}]}]}]},{"id":"severity-and-clinical-course","name":"Severity and clinical course","description":"Represent present physiological impact and its evolution.","layers":[{"id":"hydration-and-systemic-impact","name":"Hydration and systemic impact","description":"Assess fluid losses, intake and signs of serious illness in the person's clinical context.","findings":[{"id":"current-urgency-evidence","name":"Current urgency evidence","description":"Record hydration findings, ability to drink, urine output, vital signs and relevant host vulnerabilities with an explicit clinical assessment.","questions":[{"text":"What current observations describe hydration, oral intake, urine output and systemic illness?","id":"current-urgency-evidence-q01","kind":"measurement"},{"text":"Which age, nutritional, immune or other patient factors alter interpretation of these observations?","id":"current-urgency-evidence-q02","kind":"boundary"},{"text":"What escalation is indicated by the applicable clinical guidance and who is responsible for initiating it?","id":"current-urgency-evidence-q03","kind":"action"}]}]},{"id":"trajectory-and-complications","name":"Trajectory and complications","description":"Track changes in bloody diarrhoea and evidence requiring reassessment.","findings":[{"id":"episode-progression","name":"Episode progression","description":"Compare successive observations and link suspected complications to their own clinical assessments.","questions":[{"text":"How have blood in stool, stool frequency, pain, fever and hydration changed since onset and intervention?","id":"episode-progression-q01","kind":"measurement"},{"text":"Do persistent symptoms, recurrent bleeding or new systemic findings require investigation of a complication or alternative diagnosis?","id":"episode-progression-q02","kind":"action"}]}]}]},{"id":"care-decisions-and-response","name":"Care decisions and response","description":"Make episode-specific care decisions and their evidential basis inspectable.","layers":[{"id":"fluid-support-and-care-setting","name":"Fluid support and care setting","description":"Connect assessed losses and drinking ability to the responsible clinician's care plan.","findings":[{"id":"supportive-care-feasibility","name":"Supportive care feasibility","description":"Record planned fluid support, ability to receive it and the basis for the selected care setting.","questions":[{"text":"What fluid-support plan is documented, and can the person receive and tolerate it?","id":"supportive-care-feasibility-q01","kind":"action"},{"text":"What findings determine whether the current care setting and reassessment interval remain adequate?","id":"supportive-care-feasibility-q02","kind":"boundary"}]}]},{"id":"cause-directed-treatment-review","name":"Cause-directed treatment review","description":"Record medication decisions against diagnosis, contraindications and relevant guidance.","findings":[{"id":"treatment-rationale-and-safety","name":"Treatment rationale and safety","description":"Preserve the reason to start, withhold or change treatment. Include review of antimotility exposure; CDC advises against these medicines in bloody diarrhoea. [CDC treatment guidance](https://www.cdc.gov/shigella/treatment/index.html)","questions":[{"text":"What suspected or established cause and current guidance justify starting, withholding or changing an antimicrobial?","id":"treatment-rationale-and-safety-q01","kind":"action"},{"text":"Have susceptibility results, allergies, patient-specific constraints and antimotility medicine use been reviewed?","id":"treatment-rationale-and-safety-q02","kind":"action"},{"text":"What observed response or adverse effect would trigger review of the treatment decision?","id":"treatment-rationale-and-safety-q03","kind":"measurement"}]}]}]},{"id":"exposure-and-transmission-decisions","name":"Exposure and transmission decisions","description":"Connect the episode to plausible exposures and applicable precautions.","layers":[{"id":"exposure-and-cluster-context","name":"Exposure and cluster context","description":"Capture relevant food, water, travel, contact and shared-setting histories.","findings":[{"id":"plausible-acquisition-links","name":"Plausible acquisition links","description":"Represent exposures and linked illnesses as hypotheses with dates and evidence.","questions":[{"text":"Which food, water, travel, caregiving or sexual-contact exposures occurred before onset, and when?","id":"plausible-acquisition-links-q01","kind":"provenance"},{"text":"Are there similarly ill contacts or shared exposures that warrant an outbreak-assessment link?","id":"plausible-acquisition-links-q02","kind":"boundary"}]}]},{"id":"precautions-and-episode-closure","name":"Precautions and episode closure","description":"Separate clinical recovery from public-health restrictions and their release criteria.","findings":[{"id":"activity-and-clearance-decisions","name":"Activity and clearance decisions","description":"Record applicable precautions, reporting decisions and criteria for resuming relevant activities with their issuing authority.","questions":[{"text":"Which precautions or activity restrictions apply to this suspected cause, setting and jurisdiction?","id":"activity-and-clearance-decisions-q01","kind":"action"},{"text":"Which authority and dated guidance support any reporting, exclusion or clearance requirement?","id":"activity-and-clearance-decisions-q02","kind":"provenance"},{"text":"What evidence permits symptom-based episode closure, and what separate evidence is required to release transmission-related restrictions?","id":"activity-and-clearance-decisions-q03","kind":"boundary"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-kinds","name":"Kinds and varieties","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these kinds and varieties hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-identifiers","name":"Identifiers and schemes","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these identifiers and schemes hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-identifiers-q01","kind":"provenance"}]},{"id":"evidence-standards-and-regulation","name":"Standards and regulation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these standards and regulation hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-standards-and-regulation-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these real-world use hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these typical measurements hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these regional variation hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of dysentery this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Explain dysentery in general terms from health authority sources.","Urge medical care for bloody diarrhoea, especially in children and older people.","Promote handwashing, safe water and sanitation."],"mustNot":["Recommend antibiotics or other treatment without a clinician.","Serve food or water from a source linked to an outbreak.","Disclose a person's infection without lawful reason.","Stigmatize communities hit by outbreaks."],"requiresHuman":["Reporting cases to public health authorities.","Excluding a person from work in food handling or care."]},"ethics":{"considerations":["Dysentery kills children where clean water and sanitation are lacking.","Outbreaks follow war, displacement and poverty."],"affectedParties":["Children","Displaced people","Food handlers and carers"]},"owners":{"steward":"The patient with their clinicians; public health authorities handle outbreaks.","roles":[],"masterSystems":["National notifiable disease surveillance systems"]},"relations":[{"target":"Q179630","type":"parent","note":"registry parent class"},{"target":"Q2453464","type":"parent","note":"registry parent class"},{"target":"Q2970970","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.dysentery","Wikidata: Q129279 (https://www.wikidata.org/wiki/Q129279)"]},"properties":{"applicability":"not-applicable","items":["Syndrome classification: Criteria met | suspected | criteria not met | unresolved; named definition and assessment time","Visible stool blood: Present | absent | uncertain | not assessed; mixed in stool | surface only | wiping only | distribution unknown","Stool frequency: Stools per recorded observation interval, with usual baseline","Stool consistency: Formed | loose | watery | mixed | unknown","Episode duration: Hours or days from reported onset; onset uncertainty recorded","Tenesmus and abdominal symptoms: Tenesmus, cramps, pain and tenderness: present | absent | unknown; severity and location when assessed","Body temperature: Degrees Celsius, measurement method and time; reported fever recorded separately","Hydration assessment: Clinician-assigned category under a named assessment method | not assessed; supporting signs","Cause attribution: Links to suspected or established causes, with evidence, confidence and assessor","Diagnostic evidence: Links to specimens, test methods, results, collection times and interpretation","Clinical trajectory: Worsening | unchanged | improving | symptoms resolved | recurrent | unknown","Transmission-relevant context: Links to exposures, symptomatic contacts, shared settings and applicable public-health instructions"]},"recognition":{"applicability":"optional","items":["Visible blood mixed with loose stool supports recognition of the syndrome but does not establish its cause.","Visible mucus accompanying bloody diarrhea supports an inflammatory pattern but is not specific to dysentery.","Repeated small-volume bloody stools help distinguish the presentation from uncomplicated watery diarrhea, although other bowel disorders can look similar."]},"capabilities":{"applicability":"required","items":["Classify an episode against an explicit dysentery definition while preserving uncertainty.","Assemble a time-based clinical summary for assessment and escalation.","Identify missing stool observations, diagnostic evidence or severity assessments.","Check a documented treatment proposal against cause-specific guidance and patient constraints.","Track clinical response and trigger reassessment under an applicable care plan.","Support episode-specific precautions, reporting review and return-to-activity decisions."]},"hazards":{"applicability":"required","items":["Dehydration that can be fatal in young children.","Outbreaks in camps, care homes and crowded settings."]},"interfaces":{"applicability":"required","items":["The International Classification of Diseases, Tenth Revision, issued by the World Health Organization includes categories for shigellosis and amoebiasis relevant when those causes are established."]},"context":{"applicability":"required","items":["Dysentery is encountered in clinical assessment of diarrhea with visible blood and inflammatory bowel symptoms.","It is also relevant to infectious disease surveillance and outbreak investigation where contaminated food, water or person-to-person transmission may be involved.","The term describes a clinical syndrome whose cause requires assessment rather than identification from symptoms alone."]}},"sources":[{"title":"Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1 - World Health Organization (2005)","url":"","note":"Clinical picture of bacillary dysentery, epidemic S. dysenteriae type 1, control measures, case-fatality in outbreaks, and public-health response."},{"title":"The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th revision - World Health Organization (2005)","url":"","note":"Operational definition of dysentery as diarrhoea with blood in the stool and its place in primary-care treatment algorithms."},{"title":"Shigellosis - Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM, The Lancet (2018)","url":"https://doi.org/10.1016/S0140-6736(17)33296-8","note":"Species distribution, infectious dose, incubation, complications including HUS, antimicrobial resistance, and high-income versus endemic epidemiology."},{"title":"Amebiasis - Haque R, Huston CD, Hughes M, Boettner E, Petri WA Jr, New England Journal of Medicine (2003)","url":"https://doi.org/10.1056/NEJMra022710","note":"Invasive intestinal amoebiasis as amoebic dysentery, extra-intestinal abscess, diagnostic distinction from non-pathogenic Entamoeba, and treatment."},{"title":"ICD-10, chapter I (A00-A09 intestinal infectious diseases) - World Health Organization","url":"","note":"Coding split between shigellosis (A03) and acute amoebic dysentery (A06.0) rather than a single residual 'dysentery' code."},{"title":"Shigella / shigellosis disease pages and National Notifiable Diseases case definition - Centers for Disease Control and Prevention","url":"https://www.cdc.gov/shigella/","note":"Surveillance practice in the United States, sexual-network outbreaks, and organism-named reporting in place of the older syndromic label."},{"title":"Wikidata item Q129279: dysentery","url":"https://www.wikidata.org/wiki/Q129279","note":"identity and sense of the item"},{"title":"Wikipedia: Dysentery","url":"https://en.wikipedia.org/wiki/Dysentery","note":"general description of the item"}],"openQuestions":["Should the registry adopt the WHO visible-blood syndrome definition exclusively, or accommodate clinical usages that imply an infectious cause?","Which age-specific and setting-specific severity assessments should govern escalation, particularly when measurements are unavailable?","What minimum diagnostic evidence should distinguish suspected from established bacterial or amebic attribution across settings with different laboratory capabilities?","How should current local guidance address empiric treatment when etiology is unresolved, including possible Shiga toxin-producing organisms and antimicrobial resistance?","Which clinical recovery, recurrence and jurisdiction-specific transmission-clearance criteria should determine episode closure?"],"resources":{"spec":"/models/things/publications/thing-q129279/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q129279/spec.json"],"providers":["Codex","Grok"],"researchStatus":"unreviewed","generatedAt":"2026-09-07T13:26:07Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T12:16:28+00:00: completeness 1.00; sense: Wikidata description; 4 live sources; review by codex: pass","interaction.properties":"Plane INF: no invented physical properties."},"score":1.0}}