Shigellosis overview: Difference between revisions

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==Natural History, Complications and Prognosis==
==Natural History, Complications and Prognosis==
Infections are associated  mucosal ulceration, [[rectal bleeding]], drastic [[dehydration]]; fatality may be as high as 10-15% with some strains. [[Reiter's disease]], reactive [[arthritis]], and [[hemolytic uremic syndrome]] are possible sequelae that have been reported in the aftermath of shigellosis.
Infections are associated  mucosal ulceration, [[rectal bleeding]], drastic [[dehydration]]; fatality may be as high as 10-15% with some strains. [[Reiter's disease]], reactive [[arthritis]], and [[hemolytic uremic syndrome]] are possible sequelae that have been reported in the aftermath of shigellosis.
==Diagnosis==
===History and Symptoms==
Symptoms may range from mild [[abdomen|abdominal]] discomfort to full-blown [[dysentery]] characterized by [[cramps]], [[diarrhea]], [[fever]], [[vomiting]], [[blood]], [[pus]], or [[mucus]] in [[stool]]s or  [[tenesmus]]. Onset time is 12 to 50 hours.
In some persons, especially young children and the elderly, the [[diarrhea]] can be so severe that the patient needs to be hospitalized. A severe infection with high [[fever]] may also be associated with [[seizures]] in children less than 2 years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.


==References==
==References==

Revision as of 17:50, 4 December 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Shigellosis, also known as bacillary dysentery in its most severe manifestation, is a foodborne illness caused by infection by bacteria of the genus Shigella. It accounts for less than 10% of the reported outbreaks of foodborne illness in the USA. Shigellosis rarely occurs in animals; it is principally a disease of humans and primates such as monkeys and chimpanzees. The causative organism is frequently found in water polluted with human feces, and is transmitted via the fecal-oral route. The usual mode of transmission is directly person-to-person hand-to-mouth, in the setting of poor hygiene among children.

Differential Diagnosis

Many different kinds of diseases can cause diarrhea and bloody diarrhea, and the treatment depends on which germ is causing the diarrhea. Determining that Shigella is the cause of the illness depends on laboratory tests that identify Shigella in the stools of an infected person. These tests are sometimes not performed unless the laboratory is instructed specifically to look for the organism. The laboratory can also do special tests to tell which type of Shigella the person has and which antibiotics, if any, would be best to treat it. [1]

Risk Factors

In the United States, groups at increased risk of shigellosis include children in child-care centers and persons in custodial institutions, where personal hygiene is difficult to maintain; Native Americans; orthodox Jews; international travelers; men who have sex with men; and those in homes with inadequate water for handwashing.[2]

Natural History, Complications and Prognosis

Infections are associated mucosal ulceration, rectal bleeding, drastic dehydration; fatality may be as high as 10-15% with some strains. Reiter's disease, reactive arthritis, and hemolytic uremic syndrome are possible sequelae that have been reported in the aftermath of shigellosis.

Diagnosis

=History and Symptoms

Symptoms may range from mild abdominal discomfort to full-blown dysentery characterized by cramps, diarrhea, fever, vomiting, blood, pus, or mucus in stools or tenesmus. Onset time is 12 to 50 hours. In some persons, especially young children and the elderly, the diarrhea can be so severe that the patient needs to be hospitalized. A severe infection with high fever may also be associated with seizures in children less than 2 years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.

References


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