Presentation
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. [merckmanuals.com]
The natural history of endometriosis is uncertain, its etiology unknown, the clinical presentation inconsistent, diagnosis difficult and the treatment poorly standardized. [ncbi.nlm.nih.gov]
Shigella bacteria are present in the stools of infected persons while they are sick, and for up to a week or two afterwards. It has been estimated that up to 80% of all infections are the result of person-to-person transmission. [about-shigella.com]
Appropriate treatment kills the Shigella bacteria that might be present in a patient's stools and shortens the illness. [idph.state.il.us]
Entire Body System
- Fever
Mild infections cause low-grade fever (about 100.4 to 102° F [38 to 38.9° C]) and watery diarrhea 1 to 4 days after people ingest the bacteria. Some adults do not have a fever. Mild infections in adults usually resolve in 4 to 8 days. [msdmanuals.com]
Increased catabolism secondary to fever, stool protein loss, decreased intake owing to anorexia, and malabsorption can exacerbate preexisting malnutrition. [emedicine.medscape.com]
Enteric fever Enteric fever is caused by S. typhi. The bacilli enters the body via the Peyer’s patches and causes septicaemia. The first 7 to 10 days of the infection is usually asymptomatic. A high fever then develops with splenomegaly. [virology-online.com]
Mild infections cause low-grade fever (about 100.4 to 102 ° F [38 to 38.9 ° C]) and watery diarrhea 1 to 4 days after people ingest the bacteria. Some adults do not have a fever. [merckmanuals.com]
- High Fever
You should not delay getting medical treatment if you notice diarrhea, abdominal cramps, and high fever in yourself or your child. The diarrhea can be bloody or watery. The disease spreads quickly. [ectorcountyisd.org]
Chapter 5 Symptoms of Shigella Infection Symptoms of Shigella infection include painful abdominal cramps, diarrhea and fever. [about-shigella.com]
The disease causes diarrhea, abdominal cramps and high fever. Please see your doctor if you and your child show these symptoms. Please do not send your child to school until they have been cleared by your doctor to return. 2. [cbs7.com]
Some children who run high fevers with a shigella infection have seizures. It's not known whether the convulsions are a result of the fever or the shigella infection itself. If your child has a seizure, contact your doctor immediately. [drugs.com]
- Swelling
These bacterium cause disease by penetrating the lining of the large intestine, causing swelling and sores. This causes diarrhoea, fever, and stomach cramps 1-2 days after initial exposure. [healthengine.com.au]
Symptoms of Toxic Megacolon include abdominal pain and swelling, fever, weakness, and disorientation. If this complication goes untreated and the colon ruptures, the patient’s condition can be life-threatening. [foodborneillness.com]
High fever (up to 106° F [41° C]), sometimes with delirium, seizures, or coma Severe dehydration with weight loss 20 or more bowel movements a day With severe diarrhea, protrusion of part of the rectum out of the body (rectal prolapse) Rarely, marked swelling [msdmanuals.com]
High fever (up to 106° F [41 ° C]), sometimes with delirium, seizures, or coma Severe dehydration with weight loss 20 or more bowel movements a day With severe diarrhea, protrusion of part of the rectum out of the body (rectal prolapse) Rarely, marked swelling [merckmanuals.com]
- Weakness
Symptoms of Toxic Megacolon include abdominal pain and swelling, fever, weakness, and disorientation. If this complication goes untreated and the colon ruptures, the patient’s condition can be life-threatening. [foodborneillness.com]
In hemolytic-uremic syndrome, red blood cells are destroyed, causing anemia with fatigue, weakness, and light-headedness. Blood clots abnormally, causing the kidneys to stop functioning. Seizures or strokes can also occur. [msdmanuals.com]
Medical treatment In more severe cases of shigellosis, and for people with weak immune systems, doctors may prescribe an antibiotic to treat the infection. Your provider may prescribe ciprofloxacin or azithromycin. [my.clevelandclinic.org]
- Weight Loss
Children, particularly young children, are most likely to have severe complications: High fever (up to 106° F [41° C]), sometimes with delirium, seizures, or coma Severe dehydration with weight loss 20 or more bowel movements a day With severe diarrhea [msdmanuals.com]
Children, particularly young children, are most likely to have severe complications: High fever (up to 106° F [41 ° C]), sometimes with delirium, seizures, or coma Severe dehydration with weight loss 20 or more bowel movements a day With severe diarrhea [merckmanuals.com]
Gastrointestinal
- Abdominal Pain
[…] involves inflammation, haemorrhage, tissue destruction and fibrotic adhesions of the pelvic peritoneum resulting in abdominal pain and infertility. [ncbi.nlm.nih.gov]
Symptoms S. sonnei: Most common symptoms are 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]
Watery diarrhea may be accompanied by abdominal pain and marked urgency to defecate; stools may contain mucus, pus, and often blood. [merckmanuals.com]
The onset is acute, with fever, fatigue, abdominal pain and watery diarrhoea. As the disease increases in intensity, bloody diarrhoea with mucous, faecal urgency and severe cramping abdominal pain occur. [healthengine.com.au]
- Nausea
—A 23-year-old laboratory technician was admitted to the hospital on Aug. 10 with a history of fever, chills, headache, abdominal cramping, nausea, and diarrhea for four hours [jamanetwork.com]
If you have extreme nausea and vomiting, you may need intravenous fluids and medication. Most people have no lasting ill effects from shigellosis. [healthline.com]
If you have diarrhea and cannot drink fluids by mouth because of severe nausea, you may need medical care and intravenous (IV) fluids. This is more common in small children who have shigellosis. [nlm.nih.gov]
- Abdominal Cramps
You should not delay getting medical treatment if you notice diarrhea, abdominal cramps, and high fever in yourself or your child. The diarrhea can be bloody or watery. The disease spreads quickly. [ectorcountyisd.org]
—A 23-year-old laboratory technician was admitted to the hospital on Aug. 10 with a history of fever, chills, headache, abdominal cramping, nausea, and diarrhea for four hours [jamanetwork.com]
Chapter 5 Symptoms of Shigella Infection Symptoms of Shigella infection include painful abdominal cramps, diarrhea and fever. [about-shigella.com]
Clinical Features• FEVER• BLOODY DIARRHOEA• ABDOMINAL CRAMPS• TENESMUS• MUCUS, PUS• CONVULSIONS• MILD INFECTION :WATERY STOOL• BACTEREMIA - RARE• REITER,S SYNDROME• HEMOLYTIC – UREMIC SYNDROME Dr.T.V.Rao MD 32 33. [slideshare.net]
- 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. [merckmanuals.com]
[…] exposure, usually within 1 to 3 days. [1, 16] Diarrhea may range from mild to severe, and it usually contains mucus. [16] When more severe, the diarrhea is bloody 25% to 50% of the time. [1, 16, 22] Rectal spasms, which are technically referred to as “tenesmus [about-shigella.com]
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]
- Loss of Appetite
Nausea and/or vomiting, loss of appetite, headache or malaise can also occur. S. flexneri: Also causes diarrhoea, abdominal pain and cramps, and fever but is often more severe than S. sonnei infection. [ecdc.europa.eu]
History : Shigellosis starts suddenly with symptoms including painful abdominal cramps, frequent, urgent episodes of watery diarrhea, fever, chills, headache, loss of appetite (anorexia), and malaise (a vague feeling of discomfort or illness). [nmihi.com]
Besides diarrhea, shigellosis can cause: belly cramps high fever loss of appetite nausea and vomiting painful bowel movements (pooping) Shigellosis can lead to dehydration. [kidshealth.org]
Symptoms include fever, irritability or drowsiness, loss of appetite, nausea or vomiting, diarrhea, and abdominal pain. Children may frequently feel an urgent need to defecate. Within 3 days, blood, pus, and mucus appear in stool. [msdmanuals.com]
Eyes
- Prolapse
Proctitis and Rectal Prolapse: The bacteria that causes shingellosis can also cause inflammation of the lining of the rectum or rectal prolapse. [foodborneillness.com]
The first is intestinal and can include intestinal perforation, hemorrhage, rectal prolapse, paralytic ileus, and enteropathy with associated protein malabsorption. [infectionlandscapes.org]
[…] have severe complications: High fever (up to 106° F [41° C]), sometimes with delirium, seizures, or coma Severe dehydration with weight loss 20 or more bowel movements a day With severe diarrhea, protrusion of part of the rectum out of the body (rectal prolapse [msdmanuals.com]
Skin
- Erythema
Gross pathology consists of mucosal edema, erythema, friability, superficial ulceration, and focal mucosal hemorrhage involving the rectosigmoid junction primarily. [emedicine.medscape.com]
Extraintestinal complications in patients with Shigella infection include erythema nodosum, conjunctivitis, and reactive arthritis (ReA). ReA is a non-purulent joint inflammation, which can be triggered by infections in the gut or urogenital tract. [ard.bmj.com]
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
- Irritability
BACKGROUND AND AIMS: Bacterial gastroenteritis has been known as a risk factor of irritable bowel syndrome (IBS). Several risk factors of post-infectious IBS (PI-IBS) have been documented. [ncbi.nlm.nih.gov]
The bacteria release toxins that irritate the intestines. The primary symptom of shigellosis is diarrhea. [healthline.com]
Alternatives Conditions with similar symptoms include inflammatory bowel disease, irritable bowel syndrome, or other forms of infective gastroenteritis. Appropriate specialists Internist and infectious disease specialist. Last updated 6 April 2018 [nmihi.com]
- Dizziness
Also call the doctor if your child has diarrhea and shows signs of dehydration, such as: a dry or sticky mouth peeing less than usual no tears when crying dizziness or drowsiness Date reviewed: February 2019 [kidshealth.org]
You could be lightheaded, dizzy, lack tears, and sunken eyes. Watch for dry diapers in children. Post- infectious arthritis. This is joint pain (in ankles, knees, feet, hips). You could also get eye irritations and painful urination. [webmd.com]
Symptoms include lightheadedness, dizziness, lack of tears in children, sunken eyes and dry diapers. Severe dehydration can lead to shock and death. Seizures. Some children who run high fevers with a shigella infection have seizures. [drugs.com]
Signs and symptoms include lightheadedness, dizziness, lack of tears in children, sunken eyes and dry diapers. Severe dehydration can lead to shock and death. Seizures. Some children with a shigella infection have seizures. [mayoclinic.org]
- Confusion
Encephalopathy with lethargy, confusion, and headache has been noted in up to 40% of children hospitalized with Shigella infections. Reactive arthritis (also known as Reiter syndrome) may occur. [emedicine.medscape.com]
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. [nlm.nih.gov]
This can often prove confusing in identifying the exact cause or event that may have transmitted the bacteria. Shigellosis Causes There are several different species of Shigella bacteria. [healthhype.com]
- Stroke
Topics include recognizing and managing heart attacks, angina, stroke and transient ischemic attacks. [firstaidcalgary.ca]
Seizures or strokes can also occur. Some adults develop reactive arthritis (inflammation of the joints). Inflammation of the eyes (uveitis) and urethra (causing painful urination) may occur weeks to months after the diarrhea. [msdmanuals.com]
Seizures occur in approximately 10% of affected patients, and stroke or cerebral edema occur in 5%. The pathogenesis of HUS or TTP involves cytotoxic damage to the vascular endothelium. [emedicine.medscape.com]
Seizures or strokes can also occur. Some adults develop reactive arthritis (inflammation of the joints). Inflammation of the eyes ( uveitis ) and urethra (causing painful urination) may occur weeks to months after the diarrhea. [merckmanuals.com]
Workup
Blood, stool and urine specimens were collected for both bacteriological culture and parasitic workup. Concurrent infections with both Shigella sonnei and Vibrio cholerae were determined to be the cause of the infectious diarrhea. [clsjournal.ascls.org]
Shigella Infection Workup. Jun 25, 2012. Created by Jake Morgan, Michael McCoy and Kyle Trinidad, students of Tyrrell Conway at the University of Oklahoma. [microbewiki.kenyon.edu]
Serum
- Hyponatremia
In one study, hyponatremia, defined as serum sodium levels below 120 meq/L, was noted in 29% of patients hospitalized with diarrhea due to type 1 S dysenteriae. [26] However, the hyponatremia is generally caused by the syndrome of inappropriate antidiuretic [emedicine.medscape.com]
Treatment
People with mild illness usually get better on their own, with no specific treatment. [sfcdcp.org]
FINDINGS: 3649 papers were identified and 60 studies were included for analyses: 13 for mortality, 27 for diagnostic value, and 20 for treatment. [ncbi.nlm.nih.gov]
Many strains of Shigella are antibiotic-resistant, so if your doctor is going to prescribe antibiotics as a treatment, it is best that they test which strain you have to determine which antibiotic treatment will be most effective. [belmarrahealth.com]
Appropriate treatment kills the Shigella bacteria that might be present in a patient's stools and shortens the illness. [idph.state.il.us]
Prognosis
Prognosis of shigellosis The disease is self-limiting, usually resolving within 5 to 7 days without antibiotics. In severe cases, the infection may last 3 to 6 weeks. [healthengine.com.au]
What Is the Prognosis? In most cases, Shigella infections run their course in 2 to 3 days. [healthychildren.org]
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]
Prognosis Many patients with mild infections need no specific treatment and recover completely. In those with severe infections, antibiotics will decrease the length of symptoms and the number of days bacteria appear in the feces. [medical-dictionary.thefreedictionary.com]
The prognosis for shigellosis is generally good and most people recover even without medications within five to seven days. What is shigellosis? Shigellosis is a diarrheal disease caused by a group of bacteria called Shigella. [medicinenet.com]
Etiology
Mechanical, hormonal, immunological, environmental and genetic factors have been implicated in its etiology but provide inconclusive explanations. [ncbi.nlm.nih.gov]
Cohen Abstract Author Information Authors Article Metrics Metrics Shigella spp. are important etiologic agents of diarrhea worldwide. [journals.lww.com]
Epidemiology
This review summarizes the recent findings on the epidemiology, diagnosis, virulence genes, and pathobiology of Shigella infection. [ncbi.nlm.nih.gov]
The Epidemiology and the Landscape. Both sporadic and epidemic occurrence of shigellosis is common. [infectionlandscapes.org]
Pathophysiology
The improved understanding of the pathophysiology is hoped to lead to innovative therapeutic approaches against shigellosis and new generations of vaccine candidates. [ncbi.nlm.nih.gov]
References Pathophysiology of gastrointestinal infections: the role of bismuth subsalicylate. Scottsdale, Arizona, 11-14 February 1988. Proceedings. Rev Infect Dis. 1990;12 Suppl 1:S1-119. Steffen R. [cdc.gov]
Shigellosis Pathophysiology The Shigella bacteria primarily infect the epithelial cells lining intestine. It enters the gut through the mouth when consuming contaminated food and water. [healthhype.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]
Prevention
The same precautions prevent traveler's diarrhea in general. [idph.state.il.us]
The best approach for shigellosis is prevention and a few simple measures can effectively prevent the infection altogether. Supportive Treatment Proper hydration requires the use of oral rehydration solutions (ORS). [healthhype.com]