dysentery

Diarrhoea with visible blood

Retain stool consistency, change from baseline and blood observations as distinct evidence supporting classification.

1. Were loose or watery stools and visible blood observed within the same episode? definition
2. Who observed the stool, when, and was the account direct or reported? provenance
3. How did stool frequency and consistency differ from the person's usual pattern? measurement

Syndrome definition and mimics

Attach the classification to an explicit definition and preserve observations that may instead indicate another bleeding presentation.

1. Which clinical or surveillance definition supports the dysentery label? definition
2. Could the report represent isolated rectal bleeding, stool discoloration or occult blood without visible bloody diarrhoea? boundary

Supported cause attribution

Record each causal hypothesis, its supporting evidence and its unresolved alternatives without requiring a single premature diagnosis.

1. Which findings support Shigella, E. histolytica, another infectious cause or a noninfectious explanation? provenance
2. What evidence would change or overturn the current attribution? boundary

Specimen result and limitations

Keep collection timing, prior treatment, organism identification and available susceptibility information together.

1. Which specimen and method produced the result, and when was it collected relative to symptoms and treatment? provenance
2. Does the method distinguish the suspected pathogen from similar organisms or leave clinically relevant uncertainty? boundary
3. What additional testing or susceptibility evidence does the responsible clinician need before acting? action

Current urgency evidence

Record hydration findings, ability to drink, urine output, vital signs and relevant host vulnerabilities with an explicit clinical assessment.

1. What current observations describe hydration, oral intake, urine output and systemic illness? measurement
2. Which age, nutritional, immune or other patient factors alter interpretation of these observations? boundary
3. What escalation is indicated by the applicable clinical guidance and who is responsible for initiating it? action

Episode progression

Compare successive observations and link suspected complications to their own clinical assessments.

1. How have blood in stool, stool frequency, pain, fever and hydration changed since onset and intervention? measurement
2. Do persistent symptoms, recurrent bleeding or new systemic findings require investigation of a complication or alternative diagnosis? action

Supportive care feasibility

Record planned fluid support, ability to receive it and the basis for the selected care setting.

1. What fluid-support plan is documented, and can the person receive and tolerate it? action
2. What findings determine whether the current care setting and reassessment interval remain adequate? boundary

Treatment rationale and safety

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)

1. What suspected or established cause and current guidance justify starting, withholding or changing an antimicrobial? action
2. Have susceptibility results, allergies, patient-specific constraints and antimotility medicine use been reviewed? action
3. What observed response or adverse effect would trigger review of the treatment decision? measurement

Plausible acquisition links

Represent exposures and linked illnesses as hypotheses with dates and evidence.

1. Which food, water, travel, caregiving or sexual-contact exposures occurred before onset, and when? provenance
2. Are there similarly ill contacts or shared exposures that warrant an outbreak-assessment link? boundary

Activity and clearance decisions

Record applicable precautions, reporting decisions and criteria for resuming relevant activities with their issuing authority.

1. Which precautions or activity restrictions apply to this suspected cause, setting and jurisdiction? action
2. Which authority and dated guidance support any reporting, exclusion or clearance requirement? provenance
3. What evidence permits symptom-based episode closure, and what separate evidence is required to release transmission-related restrictions? boundary

Kinds and varieties

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these kinds and varieties hold for the sense of dysentery this model covers, and on what evidence? provenance

Identifiers and schemes

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these identifiers and schemes hold for the sense of dysentery this model covers, and on what evidence? provenance

Standards and regulation

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these standards and regulation hold for the sense of dysentery this model covers, and on what evidence? provenance

Real-world use

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these real-world use hold for the sense of dysentery this model covers, and on what evidence? provenance

Typical measurements

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these typical measurements hold for the sense of dysentery this model covers, and on what evidence? provenance

Failure modes and hazards

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these failure modes and hazards hold for the sense of dysentery this model covers, and on what evidence? provenance

Regional variation

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these regional variation hold for the sense of dysentery this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Reported by the breadth pass; each item needs checking against its source before it becomes normative.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of dysentery this model covers, and on what evidence? provenance