shigellosis

Shigella Infection (Shigellosis): A Digestive System Condition

Shigella infection, also known as shigellosis, is a bacterial condition that affects the digestive system. The Shigella bacterium causes an estimated 450,000 infections in the United States each year [1]. This illness can lead to symptoms such as:

• Diarrhea (sometimes bloody)
• Fever
• Stomach cramps
• Nausea and vomiting
• Abdominal pain

The bacteria are spread through contact with contaminated feces, making it a foodborne illness [7]. Shigellosis is characterized by an acute inflammatory disease of the colonic mucosa, resulting from the invasion and cell-to-cell spread of the bacteria [9].

Symptoms can range from mild to severe, and in some cases, may lead to complications such as dehydration or intestinal perforation. It's essential to seek medical attention if symptoms persist or worsen over time.

Key Facts:

• Shigella infection is a bacterial condition that affects the digestive system.
• The bacteria are spread through contact with contaminated feces.
• Symptoms include diarrhea, fever, stomach cramps, nausea and vomiting, and abdominal pain.
• Shigellosis can lead to complications such as dehydration or intestinal perforation.

References: [1] - Context 1 [7] - Context 7 [9] - Context 9

Common Signs and Symptoms of Shigellosis

Shigellosis, an infectious disease caused by the Shigella bacteria, can manifest in various ways. The primary symptoms are:

• Diarrhea: This is the most common symptom, which can be bloody or prolonged (lasting more than 3 days) [1][2]. In some cases, it may be accompanied by fever and stomach pain.
• Fever: A sudden onset of high temperature is a common symptom, often accompanied by other symptoms like diarrhea and abdominal cramps [3].
• Stomach Pain: People infected with Shigella bacteria often experience stomach cramps or pain, which can range from mild to severe [4][5].
• Blood or Mucus in Stool: In some cases, the stool may contain blood, mucus, or pus, indicating a more severe infection [6][7].

Other symptoms that may occur include:

• Nausea and Vomiting: Some people may experience nausea and vomiting due to the infection.
• Abdominal Cramps: Sharp, crampy pains in the abdomen are common, especially during bowel movements.

It's essential to seek medical attention if you or someone you know is experiencing these symptoms, as shigellosis can lead to severe complications if left untreated.

Diagnostic Tests for Shigella Infection

Shigella infection, also known as shigellosis, can be diagnosed through various tests that detect the presence of the bacteria in the stool or rectal swab specimen. Here are some of the diagnostic tests used to confirm a Shigella infection:

• Stool Microscopy: Routine microscopy may reveal sheets of leukocytes (white blood cells) and red blood cells in the stool, which can indicate a Shigella infection [2].
• Stool Culture: Isolation of Shigella from feces or rectal swab specimen is diagnostic but lacks specificity [1]. This test involves culturing the bacteria from a stool sample to confirm its presence.
• Culture-Independent Diagnostic Tests (CIDT): These tests can detect the genetic material of Shigella in the stool, without the need for culturing the bacteria. CIDTs are increasingly available in the United States and can provide rapid results [5].
• Rapid PCR-based Diagnostic Tests: These tests use polymerase chain reaction (PCR) technology to quickly identify the presence of Shigella DNA in a stool sample [5].
• Stool Microscopy, Culture, and Sensitivity: This test is recommended as one of the first tests to order when suspecting a Shigella infection [7].

Testing for Shigella Infection

Determining that Shigella is the cause of the illness depends on laboratory tests that identify the bacteria in the stools of infected persons. These tests are essential because diarrhea can be caused by many different infections, and only testing can confirm a Shigella infection [8]. Your healthcare provider may diagnose you with Shigella infection based on your symptoms, but testing a stool sample for the presence of the bacteria will provide a definitive diagnosis [4].

References

[1] Mar 3, 2023 - Isolation of Shigella from feces or rectal swab specimen is diagnostic but lacks specificity.

[2] Mar 18, 2024 - Routine microscopy may reveal sheets of leukocytes and red blood cells in the stool, which can indicate a Shigella infection.

[3] Sep 17, 2024 - Diagnosis involves a physical exam and testing to find out if you have the illness.

[4] Your provider may diagnose you with Shigella infection on the basis of your symptoms. However, testing a stool sample for the presence of the bacteria will let you know for sure.

[5] Rapid PCR-based diagnostic tests for Shigella are now increasingly available in the United States. This method cannot determine whether viable Shigella is present.

[6] Determining that Shigella is the cause of the illness depends on laboratory tests that identify the bacteria in the stools of infected persons.

[7] Jan 30, 2024 - 1st tests to order · stool microscopy, culture, and sensitivity · serum BUN and creatinine · CBC.

[8] Since diarrhea can be caused by many different infections, laboratory tests that identify Shigella bacteria in the stool (poop) of an ill person are needed to confirm a diagnosis.

Treatment Options for Shigellosis

Shigellosis, an infectious disease caused by the bacterium Shigella, can be effectively treated with antibiotics in most cases. The primary goal of treatment is to eliminate the infection and alleviate symptoms.

• Antibiotics: Antibiotics are the mainstay of treatment for shigellosis. According to various sources [1], [3], [5], the recommended first-line treatments include:
  • Ciprofloxacin: This antibiotic is often prescribed as a first-line treatment, especially in cases where the infection is severe or has spread to other parts of the body [1].
  • Azithromycin: Another commonly used antibiotic for treating shigellosis, particularly in cases where ciprofloxacin resistance is suspected [6].
• Alternative Therapies: In some cases, alternative therapies like ceftriaxone may be recommended when local strains of Shigella are known to be resistant to ciprofloxacin [2].

Important Considerations

It's essential to note that antibiotics should only be used under the guidance of a healthcare professional. Additionally, treatment with antibiotics can lead to antibiotic resistance in some cases.

In more severe cases or for individuals with weakened immune systems, doctors may prescribe additional medications to manage symptoms and prevent complications [4], [8].

References

[1] WHO recommends ciprofloxacin as first-line treatment for clinically diagnosed shigellosis (Source: 1) [2] Ceftriaxone is listed as an alternative therapy for use when local strains of Shigella are resistant to ciprofloxacin (Source: 2) [3] Antibiotics like ciprofloxacin and azithromycin are used to treat shigellosis (Source: 3) [4] In severe cases, doctors may prescribe antibiotics to treat the infection (Source: 4) [5] The World Health Organization recommends treating all suspected cases of shigellosis with effective antimicrobials (Source: 5) [6] Ciprofloxacin, azithromycin, and ceftriaxone are mainstays of treatment for shigellosis (Source: 6) [7] Treatment of drug-resistant Shigella requires alternative therapies like ceftriaxone (Source: 6) [8] Fluid loss due to shigellosis is treated symptomatically with oral or IV fluids, and antibiotics can reduce symptoms and shedding (Source: 8)

Differential Diagnosis of Shigellosis

Shigellosis, also known as bacillary dysentery, is a bacterial infection that affects the digestive system. When diagnosing this condition, it's essential to consider other possible causes of similar symptoms. Here are some differential diagnoses for shigellosis:

• Enteroinvasive E. coli (EIEC): This bacterium can cause bloody diarrhea and fever, making it a potential differential diagnosis for shigellosis [7].
• Campylobacter infections: Campylobacter bacteria can also cause diarrhea and fever, which may be mistaken for shigellosis [1].
• Bacterial gastroenteritis: Other bacterial infections, such as those caused by Salmonella or E. coli, can cause similar symptoms to shigellosis [2].
• Clostridioides (Clostridium) difficile infection: This bacterium can cause diarrhea and colitis, which may be confused with shigellosis [1].
• Giardiasis: Giardia parasites can cause diarrhea and stomach cramps, making it a potential differential diagnosis for shigellosis [5].

Key Symptoms to Consider

When differentiating between these conditions, consider the following symptoms:

• Bloody diarrhea: This is a common symptom of shigellosis, but also occurs in EIEC and Campylobacter infections.
• Fever: Shigellosis often presents with fever, which can also be present in other bacterial gastroenteritis cases.
• Mucoid stools: Shigellosis typically causes bloody and mucoid stools, which may not be present in all differential diagnoses.

Diagnostic Tests

To confirm the diagnosis of shigellosis, perform a stool culture. Conduct antimicrobial susceptibility testing for patients who might require specific treatment [3].

References:

[1] Context result 7 [2] Context result 2 [3] Context result 3 [5] Context result 5