The diagnostic step for toxic bacillary dysentery, which is more common in children, is to first obtain an epidemiological history of the patient to determine if he or she has a history of contact with dysentery patients or a history of unclean diet. Diagnosis is based on culture or genetic testing.
Clinical symptoms include high fever, severe headache, vomiting, convulsions or seizures, drowsiness, coma and cold extremities, which are typical of microcirculatory collapse and central nervous system symptoms.
In most patients, gastrointestinal symptoms are not evident. Ancillary tests such as stool tests may observe a large number of leukocytes and pus cells as well as a few red blood cells, and blood tests may show an elevated total white blood cell count, especially with a predominance of neutrophils. The diagnosis of toxic bacillary dysentery is mainly based on pathogenic tests, i.e. positive stool cultures for Bacillus dysenteriae.