Presentation
Between 5 and 10 August 2018, 45 participants presented with gastroenteritis symptoms, 14 of these tested positive for Shigella sonnei. [ecdc.europa.eu]
When people become infected, Shigella organisms are present in their stool or diarrhea. Spread of infection can occur when tiny particles of infected stool enter another person’s mouth. [sfcdcp.org]
Shigella can be present in a person’s faeces for some weeks after their symptoms have ceased, and the infection can still be passed on to others. [conditions.health.qld.gov.au]
[…] other servers: Invasive Shigella S. flexneri Giemsa Bacterial interaction Differential diagnosis Early in disease, resembles any cause of acute self limited colitis, especially other bacterial infections Clostridium difficile if pseudomembranes are present [pathologyoutlines.com]
More than 70 acute pediatric presentations are covered in a signs and symptoms section designed with side tabs for easy access. [books.google.de]
Entire Body System
- Fever
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]
These may include febrile 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. [stlukes-stl.com]
Seizures are more common in children who run a high fever, but can occur in children who do not have a high fever. It's not known whether the seizures are a result of the fever or the shigella infection itself. [mayoclinic.org]
Most people with Shigella infection have diarrhea (sometimes bloody), fever, and stomach cramps. Symptoms usually begin 1–2 days after infection and last 7 days. Most people recover without needing antibiotics. [cdc.gov]
- Reiter Syndrome
One could also ask, “Why isn’t Reiter’s syndrome called Reiter’s syndrome anymore?” [about-reactive-arthritis.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]
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]
Reactive arthritis (also known as Reiter syndrome) may occur. Complications Complications from shigellosis may be intestinal or systemic. Intestinal complications Proctitis or rectal prolapse is common in infants and young children. [emedicine.medscape.com]
- 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]
[…] bacteria (10 - 100) may cause disease The incubation period is up to one week Most patients suffer a self-limited diarrhea associated with fever and abdominal pain Initially the diarrhea is usually watery and associated with constitutional symptoms (pain, malaise [pathologyoutlines.com]
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
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]
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]
Gastrointestinal
- Diarrhea
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. [stlukes-stl.com]
- Abdominal Pain
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]
Symptoms include: Acute (sudden) abdominal pain or cramping Acute fever Blood, mucus, or pus in the stool Crampy rectal pain Nausea and vomiting Watery diarrhea Exams and Tests If you have symptoms of shigellosis, your health care provider will check [healthing.ca]
abdominal pain is common with progression to dysentery (severe diarrhea with blood or mucus in stool) occurring in up to ½ of patients, in rare instances, more commonly in children, elderly, or debilitated patients infection is fatal Shigellosis is very [pathologyoutlines.com]
- Tenesmus
Other symptoms you or your child may get include: Nausea Vomiting Fever Cramping in your stomach and abdominal area Tenesmus (the feeling that you need to go to the bathroom even when there is nothing left in your intestines) For people with mild cases [webmd.com]
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]
General Concepts Clinical Manifestations Symptoms of shigellosis include abdominal pain, tenesmus, watery diarrhea, and/or dysentery (multiple scanty, bloody, mucoid stools). [ncbi.nlm.nih.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
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]
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]
Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 110. Keusch GT. [stlukes-stl.com]
- Loss of Appetite
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]
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]
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]
Symptoms may include: diarrhea nausea and vomiting loss of appetite abdominal cramps and pain pain, bleeding, or mucus-like discharge from the rectum fever There are several different types of enteritis: Infectious enteritis The most common type of bacterial [healthline.com]
Cardiovascular
- Hypotension
[…] 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]
[…] 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]
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. [ncbi.nlm.nih.gov]
- 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.de]
Vital signs may reveal fever, tachycardia, tachypnea, and hypotension. An abdominal examination may show a distended abdomen with hyperactive bowel sounds. [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. [stlukes-stl.com]
[…] food, crowded living conditions, fly-infested environments; it affects travelers to developing countries and those living on reservations, refugee camps, institutions Incubation 1-3 days Clinical Neurologic Sx can develop in children–febrile seizures, headache [medical-dictionary.thefreedictionary.com]
- 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]
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]
These may include febrile 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. [stlukes-stl.com]
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
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]
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]
[…] 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]
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]
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
unspecified 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Applicable 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 [icd10data.com]
The inflammation can also involve the stomach (gastritis) and large intestine (colitis). In otherwise healthy people, symptoms generally go away without treatment in a few days. [cerid.uw.edu]
Pathogenesis Pathology The rectosigmoidal lesions of shigellosis resemble those of ulcerative colitis. [ncbi.nlm.nih.gov]
Colon Infectious colitis Shigella Last author update: 1 January 2016 Last staff update: 2 September 2022 Copyright: 2003-2022, PathologyOutlines.com, Inc. [pathologyoutlines.com]
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]
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]
[…] malnourished or debilitated patients are also prone to lethal infections Potential complications include severe dehydration, sepsis, perforation and toxic megacolon Obstruction, reactive arthritis, urethritis, and conjunctivitis may occur, especially with HLA-B27 [pathologyoutlines.com]
Reactive arthritis, a self-limiting sequela of S flexneri infection, occurs in an incidence as high as 2% in individuals expressing the HLA-B27 histocompatibility antigen. [ncbi.nlm.nih.gov]
Other complications include Guillain-Barré syndrome after Campylobacter enteritis, Reiter’s syndrome (especially in persons who are HLA-B27 positive), Clostridium difficile colitis after antibiotic use, and postinfectious irritable bowel. [aafp.org]
Treatment
Treatment includes antibiotics, plenty of fluids and oral rehydration drinks. [betterhealth.vic.gov.au]
People with mild illness usually get better on their own, with no specific treatment. [sfcdcp.org]
Prognosis
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 people, except malnourished children and those with weakened immune systems, recover fully. [stlukes-stl.com]
Outlook / Prognosis What is the outlook if I have shigellosis? Most people with shigellosis feel better in four to seven days, but they may still be contagious for weeks after they recover. [my.clevelandclinic.org]
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]
Etiology
Etiological and clinical characteristics of diarrhea in young adults, with special reference to Shigella gastroenteritis. [medical-dictionary.thefreedictionary.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]
The rising dominance of Shigella sonnei: An intercontinental shift in the etiology of bacillary dysentery. [revistabiomedica.org]
Recently discovered enterotoxins secreted by S flexneri may contribute to the diarrheal phase as the etiologic agents traverse the small intestine. [ncbi.nlm.nih.gov]
Epidemiology
Epidemiology and Infection. 136 (5): 577–603. doi:10.1017/S0950268807009351. PMC 2870860. PMID 17686195. ^ World Health Organization (2006). State of the art of new vaccine research and development (PDF). [en.wikipedia.org]
Epidemiologic patterns of acute diarrhea and endemic Shigella infections in children in a poor periurban setting in Santiago, Chile. [revistabiomedica.org]
As a consequence, little is known about the clinical manifestations and epidemiologic implications of shigellosis in this age group. [jamanetwork.com]
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
Sites Disease occurs primarily in the left colon and involvement of the terminal ileum is common Disease may occur in other parts of the large bowel Very rarely, fulminant disease occurs because of massive small intestinal invasion (Ikari syndrome) Pathophysiology [pathologyoutlines.com]
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]
Shigellosis is common in daycare centers and residential institutions in the United States.[9] Foodborne transmission has also been reported in the United States.[10] Outbreaks of shigellosis have also occurred in men who have sex with men.[11][12] Pathophysiology [ncbi.nlm.nih.gov]
(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
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. [stlukes-stl.com]
Good hygiene is essential to prevent the further spread of Shigella. [conditions.health.qld.gov.au]
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]
[citation needed] Prevention[edit] Simple precautions can be taken to prevent getting shigellosis: wash hands before handling food and thoroughly cook all food before eating. [en.wikipedia.org]