SHIGELLOSIS
Dr Dominique BIGBAH
OUTLINE
• 1. INTRODUCTION
• 2. DEFINITION
• 3. ETIOLOGY
• 4. CLINICAL FEATURES
• 5. DIFERENTIAL DIAGNOSIS
• 6. INVESTIGATIONS
• 7. MANAGEMENT
• 8. PREVENTION
• 9. REFERENCES
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1. INTRODUCTION
• The discovery of Shigella as the etiologic agent of dysentery (a clinical
sd of fever, intestinal cramps, and frequent passage of small, bloody,
mucopurulent stools) is attributed to the Japanese microbiologist
Kiyoshi Shiga, who isolated the Shiga bacillus (now known as Shigella
dysenteriae type 1) from patients’ stools in 1897 during a large and
devastating dysentery epidemic.
• Shigella cannot be distinguished from Escherichia coli by DNA
hybridization and remains a separate species only on historical and
clinical grounds.
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2. DEFINITION
• An acute bacterial disease involving the large and small intestine
characterised by bloody mucoid diarrhoea.
• Bacillary dysentery is a notifiable disease.
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3. ETIOLOGY
- Shigella dysenteriae,
- Shigella flexneri,
- Shigella boydii
- Shigella sonnei ( Serogroups A, B, C and D)
all spread by faecal-oral route
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4. CLINICAL FEATURES
- Mucoid bloody diarrhea
- Fever
- Nausea, vomiting, abdominal cramps
- Tenesmus (sensation of desire to defecate without production
of significant amounts of faeces)
- Toxaemia (sometimes)
- S. flexneri infection may be complicated with Reiter’s syndrome
(urethritis, conjutivitis and arthritis)
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5. DIFFERENTIAL DIAGNOSIS
- Amoebic dysentery
- Other causes of bloody diarrhoea
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6. INVESTIGATIONS
Stool: For culture and sensitivity, microscopy
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7. MANAGEMENT
• Correct any dehydration
• Ciprofloxacin 1 g single dose
• Child >3 months: 30 mg/kg twice daily for 3 days
• In case of sepsis, toxemia, severe disease or pregnancy
• Ceftriaxone IV 1 g daily till able to take oral, then switch to oral
ciprofloxacin 500 mg every 12 hours to complete 7 days
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8. PREVENTION
• Provide health education to the public about:
• – Washing hands before eating food
• – Proper disposal of faeces
• – Boiling of all drinking water
• – Avoiding eating cold foods & roadside foods
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9. REFERENCES
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WEEBALE
AKSANTI
MERCI
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GRACIAS
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