Presentation
Between 5 and 10 August 2018, 45 participants presented with gastroenteritis symptoms, 14 of these tested positive for Shigella sonnei. [ecdc.europa.eu]
His educational activities include media presentations, extramural visiting professorships, and invited lectures at national and international meetings. [books.google.com]
Clinical presentation. A 14-yearold girl was brought to Emergency Department by ambulance. The patient was presented with febrile fever (40 °C), nausea, general weakness and bloody diarrhoea. [zurnalas.llmd.lt]
The most common presentation, watery diarrhea, is indistinguishable from other bacterial, viral, and protozoan infections that induce secretory activity of intestinal epithelial cells. Fever may be present. [msdmanuals.com]
Entire Body System
- Fever
Signs and symptoms include abdominal swelling and pain, fever and weakness. [disabled-world.com]
Shigellosis or bacillary dysentery (bacterial dysentery) is an acute, highly infectious diarrheal disease with a typical mucus and blood in the stool, often accompanied by fever and abdominal cramps. Originator Shigella spp. [wikilectures.eu]
In August 2017, an outbreak of typhoid fever was reported during a European Rainbow Gathering in Italy. Shigellosis is a gastrointestinal bacterial infection. [ecdc.europa.eu]
Increased catabolism secondary to fever, stool protein loss, decreased intake owing to anorexia, and malabsorption can exacerbate preexisting malnutrition. [emedicine.medscape.com]
- Reiter Syndrome
One could also ask, “Why isn’t Reiter’s syndrome called Reiter’s syndrome anymore?” [about-reactive-arthritis.com]
Reiter’s syndrome. A review of current status and a hypothesis regarding its pathogenesis. Curr Probl Dermatol 5:157–179 PubMed Google Scholar 13. Piussan C, Pautard-Muchemble B, Pautard JC, Lenaerts C, Boudailliez B, Risbourg B (1984). [link.springer.com]
Occasionally, complications may develop, including bacteremia (bacteria in the blood), hemolytic uremic syndrome (a disorder characterized by kidney failure and anemia), and Reiter syndrome (painful urination, joint achiness). [healthychildren.org]
Reiter’s syndrome following epidemic shigellosis. J Rheumatol1981;8:969–73. ↵ Kaslow RA, Ryder RW, Calin A. Search for Reiter’s syndrome after an outbreak of Shigella sonnei dysentery. [ard.bmj.com]
Post-infection arthritis, which is also called Reiter’s syndrome or reactive arthritis. If you develop this after shigellosis, you’ll have achy joints, irritated eyes and pain when you urinate (pee). [my.clevelandclinic.org]
- Malaise
Nausea and/or vomiting, loss of appetite, headache or malaise can also occur. Clinicians should be aware of shigellosis as a potential diagnosis in persons who have returned from these gatherings and present symptoms compatible with the disease. [ecdc.europa.eu]
Along with the diarrhea there is sometimes pain, malaise and fever. DIAGNOSIS : Diagnosis is based on the finding of gull-shaped bacteria in watery, blood, leukocyte-filled feces. [atsu.edu]
The disease typically begins with constitutional symptoms such as fever, anorexia, and malaise. Initially diarrhea is watery, but subsequently may contain blood and mucus. Tenesmus is a common complaint. [medilib.ir]
- Chills
Transmission direct contact, contaminated water and food Incubation time 1-4 days [1] Clinical picture diarrhea with blood and mucus, fever, chills, chills Infectiousness highly infectious Therapy rehydration, ATB: co-trimoxazole, fluoroquinolones, rifaximin [wikilectures.eu]
You have a high fever or severe chills. You have severe nausea and are vomiting. Your mouth is dry, your lips are cracked, and you are thirsty. You are urinating less or not at all. Your heartbeat or breathing is faster than usual. [drugs.com]
The fever was low-grade, not associated with chills and rigor. There was no history of similar episode of illness in the past. On examination, the baby was irritable and had moderate pallor and signs of mild dehydration. [jlponline.org]
Gastrointestinal
- Diarrhea
NOS ( R19.7 ) functional diarrhea ( K59.1 ) infectious gastroenteritis and colitis NOS ( A09 ) neonatal diarrhea (noninfective) ( P78.3 ) psychogenic diarrhea ( F45.8 ) bacillary NOS A03.9 Infection, infected, infective (opportunistic) B99.9 ICD-10-CM [icd10data.com]
Avoid sexual activities with anyone who has diarrhea, or who recently recovered from diarrhea. [disabled-world.com]
Hemoconcentration is common, as is diarrhea-induced metabolic acidosis. [msdmanuals.com]
People with diarrhea who are unable to take fluids by mouth because of nausea may need medical attention and intravenous fluids, especially small children. [pfusion.net]
Medicines that stop diarrhea are generally not given because they can cause the infection to take longer to go away. Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. [healthing.ca]
- Abdominal Pain
Watery diarrhea may be accompanied by abdominal pain and marked urgency to defecate; stools may contain mucus, pus, and often blood. [msdmanuals.com]
Symptoms include diarrhoea, which is sometimes bloody, abdominal pain and cramps, and fever. Nausea and/or vomiting, loss of appetite, headache or malaise can also occur. [ecdc.europa.eu]
Symptoms begin hours to days after infection and may include abdominal pain, diarrhea, loss of appetite, vomiting and blood in the stool. The bacteria settle in the small intestine and cause inflammation and swelling. [cerid.uw.edu]
Symptoms of shigellosis include diarrhea (often bloody), abdominal pain, stomach cramps, and fever. Sometimes people infected with Shigella have no symptoms at all, but can still pass the bacteria to others. [health.state.mn.us]
- Tenesmus
Rectal prolapse and consequent fecal incontinence may result from severe tenesmus. However, adults may present without fever, with nonbloody and nonmucoid diarrhea, and with little or no tenesmus. [msdmanuals.com]
The symptoms include: colitis (hemorrhagic inflammation of mucous membranes), fever, diarrhea, vomiting, stomachaches, tenesmus, and mucous and bloody stools. ▲Page top [fukushihoken.metro.tokyo.lg.jp]
[…] convulsions and symptoms of meningeal irritation in children), chills, cramping abdominal pain, located more to the left, diarrhea – first large watery stools, with a decrease in temperature it turns into numerous small stools with blood and mucus, painful tenesmus [wikilectures.eu]
Symptoms of shigellosis typically start 1–2 days after exposure and include: Diarrhea (sometimes bloody) Fever Abdominal pain Tenesmus (a painful sensation of needing to pass stools when bowels are empty) Shigella germs are present in the feces (poop) [cdc.gov]
Signs and Symptoms A Shigella infection can cause mild watery or loose stools with no other symptoms, or it can be more serious, with fever, abdominal cramps or tenderness, crampy rectal pain (tenesmus), and mucous-filled and sometimes bloody stools. [healthychildren.org]
- Food Poisoning
Some of the common causes of food poisoning include Staphylococcal food poisoning (005.0); botulism food poisoning, including Clostridium botulinum (005.1); Clostridium perfringens (005.2); Salmonella gastroenteritis (003.0); bacterial food poisoning [fortherecordmag.com]
Reporting the food poisoning episode Any suspected case of food poisoning from eating takeaway or restaurant food should be reported to the local Environmental Health Office. [patient.info]
Enteritis is commonly referred to as "food poisoning." It is most often caused by eating or drinking things that are contaminated with bacteria or viruses. [cerid.uw.edu]
- Loss of Appetite
Nausea and/or vomiting, loss of appetite, headache or malaise can also occur. Clinicians should be aware of shigellosis as a potential diagnosis in persons who have returned from these gatherings and present symptoms compatible with the disease. [ecdc.europa.eu]
Symptoms begin hours to days after infection and may include abdominal pain, diarrhea, loss of appetite, vomiting and blood in the stool. The bacteria settle in the small intestine and cause inflammation and swelling. [cerid.uw.edu]
Enteritis can cause abdominal pain, severe diarrhea, vomiting, and loss of appetite. Treatment usually involves drinking fluids to prevent dehydration. In rare cases, enteritis may be treated in a hospital with intravenous (IV) fluids. [kidshealth.org]
Cardiovascular
- Hypotension
[…] chloroquine chronic coronary decrease depends depression diarrhoea diazepam digitalis digoxin dilatation disease diuretics dopamine dose doxycycline duration of action effect enzyme excretion fall in BP fluid GABA given Gram heart hepatic hypertension hypotension [books.google.com]
[…] chronic coronary damage decrease depends depression diarrhoea diazepam digitalis dilatation disease diuretics dopamine dose doxycycline drug duration of action effect enzyme excretion fall in BP fluid furosemide GABA given Gram heart hepatic hypertension hypotension [books.google.de]
She is admitted and quickly develops hypotension, toxic megacolon and multiorgan failure. She is started on broad spectrum antibiotic therapy. A nucleic acid amplification test (NAAT) for the Clostridium difficile toxin gene is negative. [pathologyoutlines.com]
Endotoxic shock is characterized by blood pools forming in the microcirculation resulting in hypotension. Vital organs lack adequate blood supply, leading to decreased tissue perfusion, acidosis, ischemia, and cellular hypoxia. [de.slideshare.net]
Vital signs may reveal fever, tachycardia, tachypnea, and hypotension. An abdominal examination may show a distended abdomen with hyperactive bowel sounds. [statpearls.com]
- Tachycardia
[…] peripheral phenytoin plasma concentration platelet prevent produce prophylaxis protein quinolones receptors reduces reflex release renal resistance respiratory response Rifampicin sedation soluble stimulation sulfonamides sympathetic syndrome synthesis tachycardia [books.google.com]
Vital signs may reveal fever, tachycardia, tachypnea, and hypotension. An abdominal examination may show a distended abdomen with hyperactive bowel sounds. [statpearls.com]
Skin
- Erythema
With frequencies indicated in Figure 22-2, there is proximal extension of erythema, edema, loss of vascular pattern, focal hemorrhage, and adherent layers of purulent exudate. [ncbi.nlm.nih.gov]
Neurologic
- Headache
A brain disease (encephalopathy) with headache, lethargy, confusion, and stiff neck can also develop. [healthing.ca]
Go to the emergency room if these symptoms occur in a person with shigellosis: Confusion Headache with stiff neck Lethargy Seizures These symptoms are most common in children. [nicklauschildrens.org]
- Febrile Seizures
seizures, headache, lethargy, confusion, nuchal rigidity McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc. [medical-dictionary.thefreedictionary.com]
Children may develop febrile seizures if fever accompanies the diarrhea. 1 Sometimes afebrile seizures may occur in association with dehydration, electrolyte imbalance, hypoglycemia or hypocalcaemia and complicate acute gastroenteritis. [pjms.com.pk]
These may include febrile seizures (also called a “fever fit”) when body temperature rises quickly and the child has seizures. A brain disease (encephalopathy) with headache, lethargy, confusion, and stiff neck can also develop. [healthing.ca]
seizures (also called a "fever fit") when body temperature rises quickly and the child has seizures, or a brain disease (encephalopathy) with headache, lethargy, confusion, and stiff neck. [nicklauschildrens.org]
These may include febrile seizures (also called a "fever fit") when body temperature rises quickly and the child has seizures. A brain disease (encephalopathy) with headache, lethargy, confusion, and stiff neck can also develop. [medlineplus.gov]
- Meningism
K1 is also associated with neonatal meningitis since it is antiphagocytic, anticomplementary, and resembles sialic acid. As a rule, K-antigen is responsible for type specifity. [de.slideshare.net]
Clinical symptoms[edit | edit source] Sudden fever (febrile convulsions and symptoms of meningeal irritation in children), chills, cramping abdominal pain, located more to the left, diarrhea – first large watery stools, with a decrease in temperature [wikilectures.eu]
A03.9 Shigellosis, unspecified 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Applicable To Bacillary dysentery NOS Group A A03.0 ICD-10-CM Codes Adjacent To A03.0 A02.20 Localized salmonella infection, unspecified A02.21 Salmonella meningitis [icd10data.com]
[…] infection or foodborne intoxication due to any Salmonella species other than S. typhi and S. paratyphi A02.0 Salmonella enteritis Salmonellosis A02.1 Salmonella septicaemia A02.2 Localized salmonella infections Salmonella: · arthritis+ ( M01.3* ) · meningitis [apps.who.int]
Brain abscesses give rise to the symptoms of meningitis. DIAGNOSIS : The diagnosis of amebiasis is made by identifying E. histolytica in the feces or in tissues obtained from lesions. [atsu.edu]
Workup
See Workup for more detail. Management Maintain hydration to compensate for fluid losses from diarrhea. Antibiotic treatment is indicated in most patients with a positive stool culture for Shigella. Treatment can reduce symptoms by 2 days. [emedicine.medscape.com]
Colonoscopy
- Colitis
To Infectious colitis NOS Infectious enteritis NOS Infectious gastroenteritis NOS Type 1 Excludes colitis NOS ( K52.9 ) diarrhea NOS ( R19.7 ) enteritis NOS ( K52.9 ) gastroenteritis NOS ( K52.9 ) noninfective gastroenteritis and colitis, unspecified [icd10data.com]
Ischemic colitis may also cause pseudomembranous colitis; however, the patient presented with infectious symptoms and sepsis. [pathologyoutlines.com]
Seite 122 - ML (1983) Hemorrhagic colitis associated with a rare Escherichia coli serotype. [books.google.de]
Catarrh, enteric or intestinal Colitis Enteritis Gastroenteritis } } } NOS haemorrhagic septic Diarrhoea: · NOS · dysenteric · epidemic Infectious diarrhoeal disease NOS Excludes: due to bacterial, protozoal, viral and other specified infectious agents [apps.who.int]
HLA Type
- HLA-B27
It is thought that HLA-B27 may affect the elimination of the infecting bacteria or an individual’s immune response. [1] HLA-B27 has been shown to be a predisposing factor in one-half to over two-thirds of individuals with reactive arthritis. [8,1] While [about-reactive-arthritis.com]
One of the animals had a major histocompatibility class I allele with some sequence similarity to HLA-B27. This allele is associated with postinfection reactive arthritis in humans. PDF emailed within 1 workday: $29.90 Credit Card PayPal [eurekamag.com]
Opportunities may occur for aberrant interactions between Shigella antigenic peptides and HLA-B27; studies have shown that the profile of peptides which can be eluted from cell surface HLA-B27 molecules changes drastically after infection with Shigella [ard.bmj.com]
Approximately 70% of patients with post-shigellosis reactive arthritis are HLA-B27 positive. [28] Hemolytic-uremic syndrome (HUS) is a relatively uncommon disease; however, it is the most frequent cause of acute renal failure among infants and young children [emedicine.medscape.com]
This peptide has sequence similarity to the HLA B27 alpha 1 domain, suggesting that molecular mimicry may play a pathogenetic role in arthritis. (See "Pathogenesis of spondyloarthritis".) [medilib.ir]
Treatment
THE EVOLUTION OF THE TREATMENT: Over the past years, strains of Shigella sonnei have become resistant to aminopenicillin and cotrimoxazole (treatment recommended till now) and now predominate. [ncbi.nlm.nih.gov]
Treatment includes antibiotics, plenty of fluids and oral rehydration drinks. [betterhealth.vic.gov.au]
Prognosis
Shigellosis Microchapters Home Patient Information Overview Historical Perspective Pathophysiology Classification Causes Differentiating Shigellosis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis [wikidoc.org]
Outlook (Prognosis) The infection can be mild and goes away on its own. Most people, except malnourished children and those with weakened immune systems, typically recover fully. [healthing.ca]
Outlook (Prognosis) The infection is often mild and goes away on its own. Most patients, except malnourished children and those with weakened immune systems, recover fully. [nicklauschildrens.org]
Outlook (Prognosis) The infection is often mild and goes away on its own. Most people, except malnourished children and those with weakened immune systems, recover fully. [stlukes-stl.com]
Etiology
Etiological and clinical characteristics of diarrhea in young adults, with special reference to Shigella gastroenteritis. [medical-dictionary.thefreedictionary.com]
Consequently, only limited information about epidemiology and etiology of diarrheal infections in adults residing in developing countries are available [17,18,19]. [bmcresnotes.biomedcentral.com]
MM 237-240, 619-621; ID 736-741, 747-752, 763-768, 721-723 SHIGELLOSIS ETIOLOGICAL AGENTS : Fifty Shigella species which fall into one of four serological groups. [atsu.edu]
Shigellosis is an acute infection with onset of symptoms usually occurring within 24-48 hours of ingestion of the etiologic agent. [de.slideshare.net]
[…] diarrhea with blood and mucus, fever, chills, chills Infectiousness highly infectious Therapy rehydration, ATB: co-trimoxazole, fluoroquinolones, rifaximin Classifications and references MedlinePlus 000295 Medscape 968773 Shigella flexneri Gram's staining Etiology [wikilectures.eu]
Epidemiology
Shigellosis Microchapters Home Patient Information Overview Historical Perspective Pathophysiology Classification Causes Differentiating Shigellosis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis [wikidoc.org]
As a consequence, little is known about the clinical manifestations and epidemiologic implications of shigellosis in this age group. [jamanetwork.com]
Epidemiology[edit | edit source] The source of infection is contaminated food, sick or convalescent person. [wikilectures.eu]
Epidemiology and pathogenesis of diarrhea caused by E.coli. 5. Laboratory diagnostics of the coli-enteritis. 6. Cultural method 7. Prevention and control of the diarrhea provoked E.coli. 8. Epidemiology and pathogenesis of bacterial dysentery. [de.slideshare.net]
Pathophysiology
Shigellosis Microchapters Home Patient Information Overview Historical Perspective Pathophysiology Classification Causes Differentiating Shigellosis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis [wikidoc.org]
Chemotherapy-induced diarrhea: pathophysiology, frequency and guideline-based management. Ther Adv Med Oncol. 2010 Jan; 2(1): 51–63. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126005/. Accessed March 2016. [labtestsonline.it]
[…] in the U.S. since 2013 (CDC: 2019 Antibiotic Resistance Threats Report [Accessed 21 February 2023]) A recent extensively drug resistant Shigella sonnei outbreak was detected in the United Kingdom between 2021 - 2022 (Lancet Infect Dis 2022;22:1503) Pathophysiology [pathologyoutlines.com]
(See "Clinical manifestations and diagnosis of Shiga toxin-producing Escherichia coli (STEC) hemolytic uremic syndrome (HUS) in children" and "Pathophysiology of TTP and other primary thrombotic microangiopathies (TMAs)".) [medilib.ir]
No vaccine against Shigella species exists yet, however, several are under development. [4, 5, 6, 7] Pathophysiology Shigella organisms cause bacillary dysentery, [8, 9, 10] a disease that has been described since early recorded history. [emedicine.medscape.com]
Prevention
Good hygiene is essential to prevent the further spread of Shigella. [conditions.health.qld.gov.au]
Shigellosis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis Diagnosis History and Symptoms Physical Examination Laboratory Findings Other Diagnostic Studies Treatment Medical Therapy Primary Prevention [wikidoc.org]
Prevention Prevention includes properly handling, storing, and preparing food, and good personal hygiene. Handwashing is the most effective way to prevent shigellosis. Avoid food and water that may be contaminated. References Bhutta ZA. [healthing.ca]
Prevention Prevention includes properly handling, storing, and preparing food, and good personal hygiene. Hand washing is the most effective way to prevent shigellosis. Avoid food and water that may be contaminated. visHeader References DuPont HL. [nicklauschildrens.org]
Prevention Prevention includes properly handling, storing, and preparing food, and good personal hygiene. Handwashing is the most effective way to prevent shigellosis. Avoid food and water that may be contaminated. References Melia JMP, Sears CL. [ssl.adam.com]