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]
Tick-borne Rickettsia rickettsii Rocky Mountain spotted fever Rickettsia conorii Boutonneuse fever Rickettsia japonica Japanese spotted fever Rickettsia sibirica North Asian tick typhus Rickettsia australis Queensland tick typhus Rickettsia honei Flinders [en.wikipedia.org]
- Pain
It causes significant morbidity due to pelvic pain and infertility among 15-25% of women during their reproductive age. [ncbi.nlm.nih.gov]
In adults, the first symptoms may be painful abdominal cramps and a frequent urge to defecate. Passing stool may temporarily relieve the pain. These symptoms may become more severe and occur more frequently as the infection progresses. [msdmanuals.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]
- Reiter Syndrome
Reiter's syndrome is caused by a reaction to Shigella infection that happens only in people who are genetically predisposed to it. [idph.state.il.us]
One of those complications is a condition known as Reiter’s syndrome, which is a reactive arthritis that typically follows a bacterial infection. [belmarrahealth.com]
This condition is called Reiter's syndrome. It can last for months or years, and can lead to chronic arthritis which is difficult to treat. [textbookofbacteriology.net]
Reiter’s syndrome in a five-year-old girl. Arthritis Rheum1980;23:960–1. ↵ Simon DG, Kaslow RA, Rosenbaum J, Kaye RL, Calin A. Reiter’s syndrome following epidemic shigellosis. [ard.bmj.com]
- Malaise
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]
Symptoms include fever, abdominal pain, malaise and bloody or watery diarrhea. While Shigella-induced diarrhea usually subsides even without treatment, antibiotics may be administered to stop diarrhea sooner. [techtimes.com]
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]
Symptoms of shigella typically include watery or bloody diarrhea with abdominal pain, fever and malaise. [sfgate.com]
Symptoms The usual symptoms are diarrhea associated with cramping, abdominal pain, chills, and malaise, headache, and fever. The diarrhea often contains blood and mucus. The patient may become progressively weaker and more dehydrated. [healthcentral.com]
- Falling
Abortions Alcohol Assisted insemination Asthma and hay fever Bites, burns, cuts and pests Blood, organ and tissue Cancer Challenging behaviour Chemicals and contaminants Diabetes Dementia Dental care Drugs End of life care Essure contraceptive device Falls [sahealth.sa.gov.au]
The county says they’ve been battling a Shigellosis outbreak since last fall. The infectious disease is caused by bacteria. People who have it usually have a fever and can suffer from stomach cramps or diarrhea. [wifr.com]
Current recommendations include antibiotic treatment of asymptomatic carriers only if they fall into a priority group (young child, food handler, health care worker, resident of an institution, or immunosuppressed). [www2.health.vic.gov.au]
Respiratoric
- Pneumonia
Intradermally administered PSSP-1 induced strong serum antibody responses but failed to induce protection in the mouse lung pneumonia model. [ncbi.nlm.nih.gov]
Their findings may apply to additional bacterial species, including Salmonella and those responsible for typhoid fever, bubonic plague and many hospital-acquired pneumonias. [sciencedaily.com]
[…] annotations containing back-references to A03.9 : Use Additional: D59.3 ICD-10-CM Diagnosis Code D59.3 Hemolytic-uremic syndrome 2016 2017 2018 2019 Billable/Specific Code Use Additional code to identify associated: E. coli infection ( B96.2- ) Pneumococcal pneumonia [icd10data.com]
Rhinoscleroma, Klebsiella pneumonia Klebsiella granulomatis Granuloma inguinale Klebsiella oxytoca Escherichia coli : Enterotoxigenic Enteroinvasive Enterohemorrhagic O157:H7 O104:H4 Hemolytic-uremic syndrome Enterobacter aerogenes / Enterobacter cloacae [en.wikipedia.org]
Infect Immun 69:3271–3285 PubMed Google Scholar Voino-Yasenetsky MV, Voino-Yasenetskaya MK (1961) Experimental pneumonia caused by bacteria of the Shigella group. [link.springer.com]
Gastrointestinal
- Diarrhea
All cause diarrhea. However, one—Shigella dysenteriae—is more likely to cause severe diarrhea, dysentery, and complications. [msdmanuals.com]
Many different kinds of diseases can cause diarrhea and bloody diarrhea. Effective treatment depends on which germ is causing the diarrhea. [idph.state.il.us]
Clostridium difficile is the main cause of nosocomial diarrhea mainly in elderly hospitalized patients and in nursing homes, but less common in the community. [ncbi.nlm.nih.gov]
Hemoconcentration is common, as is diarrhea-induced metabolic acidosis. [merckmanuals.com]
Diagnosis and Treatment Shigella is diagnosed by health professionals by collecting a sample of stool or diarrhea, and sending it to a microbiology laboratory for culture. [sfcdcp.org]
- 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. [medlineplus.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]
Skin
- Ulcer
Severe mucosal ulcerations may cause significant acute blood loss. [merckmanuals.com]
Inflammation and ulceration of the lower part of the bowel occurs in most cases, displaying itself as bloody stools. [ecdc.europa.eu]
The pathogenesis of shigellosis involves inflammation, ulceration, haemorrhage, tissue destruction and fibrosis of the colonic mucosa resulting in abdominal pain and diarrhoea/dysentery, this is similar to the pathogenesis of endometriosis which also [ncbi.nlm.nih.gov]
Colonoscopy (examination of the inside of the colon using a lighted, magnification instrument) may reveal areas of congested rectal mucosa, small flat irregular blue or purple spots (ecchymoses), and sometimes large areas of ulceration. [nmihi.com]
Neurologic
- Seizure
Neurologic disease: Seizures, the most common neurologic complication, are always associated with fever and are generalized. They are typically nonrecurring and uncomplicated. Seizures are least common with S dysenteriae. [emedicine.medscape.com]
Seizures. Some children with a shigella infection have seizures. Seizures are more common in children who run a high fever, but can occur in children who do not have a high fever. [mayoclinic.org]
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: Some children who run high fevers with a shigella infection experience seizures. It is not known whether the convulsions are a result of the fever, or the shigella infection itself. [disabled-world.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]
- Headache
—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]
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. [medlineplus.gov]
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]
- 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]
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]
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]
These may worsen the condition of a patient with dysentery or colitis. [medical-dictionary.thefreedictionary.com]
Pathogenesis Pathology The rectosigmoidal lesions of shigellosis resemble those of ulcerative colitis. [ncbi.nlm.nih.gov]
Dx left sided mild colitis Nov'13 Dx redness in the rectum Feb'14 Current medication - Pentasa 4g, Entocort enema(nightly) Supplements - Psyllium pwoder [healingwell.com]
Infection does not become chronic and is not an etiologic factor in ulcerative colitis. [merckmanuals.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]