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Shigellosis is an acute bacterial infection of the lining of the intestines.
Alternative NamesShigella gastroenteritis; Shigella enteritis; Enteritis - shigella; Gastroenteritis - shigella
Causes, incidence, and risk factorsShigellosis is caused by a group of bacteria called Shigella.
There are several types of Shigella.
- Shigella sonnei, also called "group D" Shigella, is responsible for most cases of shigellosis in the United States.
- Shigella flexneri, or "group B" Shigella, cause almost all other cases.
- Shigella dysenteriae type 1 is rare in the U.S. but can lead to deadly outbreaks in developing countries.
People infected with the bacteria release it into their stool. The bacteria can spread from an infected person to contaminate water or food, or directly to another person. Getting just a little bit of the Shigella bacteria into your mouth is enough to cause symptoms.
Outbreaks of shigellosis are associated with poor sanitation, contaminated food and water, and crowded living conditions.
Shigellosis is common among travelers in developing countries and workers or residents of refugee camps.
There are about 18,000 cases of shigellosis per year in the United States. The condition is most commonly seen in day care centers and similar places.
SymptomsSymptoms usually develop about 1 to 7 days (average 3 days) after you come in contact with the bacteria.
Symptoms include:
- Acute (sudden) abdominal pain or cramping
- Acute (sudden) fever
- Blood, mucus, or pus in stool
- Crampy rectal pain (tenesmus)
- Nausea and vomiting
- Watery diarrhea
- Dehydration with fast heart rate and low blood pressure
- Abdominal tenderness
- Elevated white blood cell count
- Stool culture
- White blood cells in stool
The symptoms usually last 2 to 7 days. The goal of treatment is to replace fluids and electrolytes (salt and minerals) lost in diarrhea.
Medications that stop diarrhea are generally not given because they may prolong the course of the disease.
Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. Several varieties of electrolyte solutions are now available over the counter.
Antibiotics can help shorten the length of the illness and help prevent it from spreading to others in group living or day care situations. They may also be prescribed for patients with severe symptoms. Frequently used antibiotics include sulfamethoxazole and trimethoprim (Bactrim), ampicillin, ciprofloxacin (Cipro), or azithromycin.
Persons with diarrhea who cannot drink fluids by mouth because of nausea may need medical attention and fluids through a vein ( intravenously).This is especially common in small children.
Persons who take diuretics ("water pills") may need to stop taking such medicines if they have acute shigella enteritis. Never stop taking any medicine without first talking to your health care provider.
Expectations (prognosis)Often the infection is mild and goes away on its own. Most patients, except malnourished children and those with weakened immune systems, have an excellent outlook.
ComplicationsComplications may include:
- Dehydration - severe
- Hemolytic-uremic syndrome (HUS), a form of kidney failure with anemia and clotting problems
- Reactive arthritis
Up to 40% of children with severe shigella enteritis develop neurological problems including febrile seizures or brain disease (encephalopathy) with headache, lethargy, confusion, and stiff neck.
Calling your health care providerCall your provider if diarrhea does not improve, if there is blood in the stool, or if there are signs of dehydration.
Go to the emergency room if the following occur in a person with shigellosis:
- Confusion
- Headache with stiff neck
- Lethargy
- Seizures
Such symptoms are most common in children.
PreventionPrevention involves the proper handling, storage, and preparation of food, in addition to good cleanliness. Hand washing is the most effective preventive measure. Avoid contaminated food and water.
ReferencesDuPont HL. Shigella species (bacillary dysentery). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 224.
Ochoa TJ, Cleary TG. Shigella. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 196.
What else can I help you with?
What complication can shigellosis cause to the skin?
Shigellosis can cause skin rash.
What are some good questions to ask your doctor about Shigellosis?
* What is shigellosis? * What sort of germ is Shigella? * How can Shigella infections be diagnosed? * How can Shigella infections be treated? * Are there long term consequences of a Shigella infection? * How do people catch Shigella? * What can a person do to prevent this illness? * How common is shigellosis? * What else can be done to prevent shigellosis? * What is the government doing about shigellosis? * How can I learn more about this and other public health problems? * Some tips for preventing the spread of shigellosis
What is the condition known as shigellosis?
Shigellosis is an infection of the intestinal tract by a group of bacteria called Shigella.
What complication can shigellosis inflict on the joints?
Shigellosis can lead to an unusual form of arthritis called Reiter's syndrome.
What complications can shigellosis inflict on the nervous system?
Shigellosis can cause irritation of the meninges or meningitis, encephalitis, and seizures.
What does severe dehydration from shigellosis require?
Severe dehydration from shigellosis usually requires intravenous fluid replacement.
How long does shigellosis last?
Shigellosis can last from a few days to several weeks, with an average of seven days.
What complications can shigellosis cause to the kidneys?
Shigellosis can cause hemolytic uremic syndrome or HUS which leads to kidney failure.
What are commonly known facts about shigellosis?
Shigellosis is a well-known cause of traveler's diarrhea and illness throughout the world.
Where do most deaths from shigellosis occur?
Most deaths are in less-developed or developing countries, but even in the United States, shigellosis can be a dangerous and potentially deadly disease.
Why does the outbreak of shigellosis decline during holidays?
Shigellosis in schools or day care settings almost always disappears when holiday breaks occur, which sever the chain of transmission.
How can suspicion of shigellosis be confirmed?
Shigellosis is one of the many causes of acute diarrhea. Culture (growing the bacteria in the laboratory) of freshly obtained diarrhea fluid is the only way to be certain of the diagnosis.
