Shigellosis is a gut infection caused by Shigella bacteria, which spread very easily from person to person or through food and water because only a few germs are needed. It is common in childcare settings, among travelers and in men who have sex with men.
Key symptoms
- Watery diarrhea that turns into small, frequent bloody stools with mucus
- Fever and crampy abdominal pain
- Painful urge to pass stool (tenesmus)
- Febrile seizures in some young children
What you find on exam
- Fever and signs of dehydration
- Lower abdominal tenderness
- Mental status in children
- Rectal prolapse in young children
Tests
- Stool culture with susceptibility testing, or PCR panel followed by culture
- Blood count, electrolytes and kidney function if severe
- Report to public health
Treatment basics
- Oral or IV fluids
- Antibiotics for severe illness, high-risk patients or outbreak control, guided by susceptibility
- Azithromycin, ciprofloxacin or ceftriaxone depending on resistance
- Avoid antimotility drugs
- Hand washing; no childcare, food handling or sex until symptoms resolve
Red flags
- Severe dehydration or confusion
- Seizures in a child
- Low urine output, pallor or bruising (hemolytic uremic syndrome)
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; CDC, Hand Hygiene in Healthcare Settings. Written by Making Synapses. Making Synapses is not affiliated with these organizations.