SHIGELLOSIS

SHIGELLOSIS

Shigellosis, a type of food poisoning infection caused by the Shigella species (i.e. Shigella flexneri, Shigella dysenteriae, Shigella sonnei, Shigella boydii), is a major public health dilemma in third-world world countries, especially where sanitation is inadequate. Shigellosis is commonly transmitted through the fecal-oral mode of transmission.

Shigella’s mode of transmission is with direct contact with the pathogen that is present in feces. For example, this could occur in a neonatal care facility where staff doesn’t observe proper handwashing procedures after changing a neonate’s diaper. Shigella species can also spread if the fecal matter comes into contact with food, drinking water, or pool water.

There are certain demographics which predispose to an increased risk of shigellosis. Children under the age of five are most likely to be infected with Shigella bacteria. However, this may not be true most of the time, as it can occur at any age.

A mild case of shigellosis usually resolves within three days to a week. Cases unresolved within a month are rare. However, when immediate treatment is needed, doctors usually prescribe a course of antibiotics that has coverage to Shigella bacteria.

SYMPTOMS

Signs and symptoms of shigellosis include:

  • Acute bloody diarrhea
  • Abdominal cramping
  • Tenesmus
  • Urgency
  • Fever
  • Occasional vomiting
  • Dehydration

DIAGNOSIS

Fecalysis or a stool exam should be performed for all possible cases of shigellosis. Specimens should immediately be processed. A complete blood count (CBC) and other laboratory tests may be performed in patients with serious symptoms or to find out other differential diagnoses.

 

TREATMENT

General supportive care of patients with shigellosis includes the following:

  • High fever in children should be treated with antipyretics.
  • Narcotic-related antidiarrheals i.e. diphenoxylate and atropine should be avoided.
  • The initiation of antibiotic treatment is recommended in most patients. However, antibiotic-resistant strains of Shigella have emerged; therefore, finding out whether the pathogen is resistant is crucial.
  • Drinking clear liquids to be followed by a lactose-free diet may be doneuntil symptoms of the infection appear to be
  • Antimotility agents should be avoided. Thesemay exacerbate symptoms and may result in toxic dilation of the colon.
  • Oral rehydration solutions are preferable for fluid and electrolyte supplementation.

Seek immediate help from a gastroenterologist (an internist who specializes in treating diseases of the gastrointestinal tract) or an infectious diseases expert if the infection has extended or if the patient experiences a serious case of shigellosis that is resistant to antibiotics.

Patient education regarding proper hygiene is a must. Careful handwashing and proper fecal waste management should be done to prevent the spread of shigellosis. Therefore, primary preventive measures should include the provision of potable water, implementation of appropriate sanitation methods, and watchful use of personal hygiene and food hygiene.

 

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