Shigella enteritis

Alternative names

Shigellosis; Shigella gastroenteritis

Definition

Shigella enteritis is an acute infection of the lining of the small intestine caused by 1 of 4 different strains of the shigella bacteria.

Causes, incidence, and risk factors

Outbreaks of shigella enteritis are associated with poor sanitation, inadequate water supplies, contaminated food, crowded living conditions, and fly-infested environments.

Shigella enteritis is common among travelers in developing countries and workers or residents of reservations, refugee camps, and similar institutions. The incubation period is 1 to 7 days, with an average of 3 days.

Although uncommon in adults, neurologic symptoms can develop in children. In up to 40% of children with severe shigella enteritis, febrile seizures, headache, Lethargy, confusion, and stiff neck resembling Meningitis (nuchal rigidity) can occur.

There are about 18,000 cases of shigella enteritis per year in the US.

Symptoms

• Acute Abdominal pain or cramping
  
• Tenesmus (crampy rectal pain)
  
• Watery diarrhea
  
• nausea and Vomiting
  
• Acute fever
  
• Blood, mucus, or pus in stool
  

Signs and tests

• Dehydration with fast heart rate and Low Blood pressure
  
• Abdominal tenderness
  
• Elevated white blood cell count
  
• Stool culture
  
• White blood cells in stool
  

Treatment
The natural course of the disease is 2-3 days. The objective of treatment is to replace fluids and electrolytes (salt and minerals) lost in diarrhea.

Antidiarrheal medications are generally not given because they may prolong the course of the disease.

Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. Several varieties of electrolyte solutions are now available over the counter.