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By ULY CLINIC

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Shigellosis

 

Introduction

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Shigella organisms are a group of gram-negative, facultative intracellular bacteria pathogens. They are grouped into 4 species: Shigella dysenteriae, Shigella flexneri, Shigella boydii, and Shigella sonnei, also known as groups A, B, C, and D respectively. Shigellosis is spread by means of fecal-oral, by igestion by ingestion of contaminated food or water and leads to bacillary dysentery. 

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Diagnostic Criteria

 

  • Acute abdominal cramping, high-grade fever, emesis and large-volume watery diarrhea

  • Tenesmus, urgency, fecal incontinence, mucoid bloody diarrhea 

  • Severe headache, lethargy, meningismus, delirium, and convulsions

  • Hemolytic uremic syndrome (HUS), microangiopathic hemolytic anemia, thrombocytopenia, and renal failure 

  • Profound dehydration and hypoglycemia PLUS

  • Laboratory evidence of microscopic isolation of the bacteria from stool or rectal swabs specimens OR

  • Stool culture for suspected cases in early course of infection  OR 

  • An enzyme immunoassay (ELISA) for shiga toxin detection in stool for S. dysenteriae type-1. 

 

Pharmacological Treatment

 

  • Ciprofloxacin (PO) 500mg 12 hourly for 5 days 

OR 

  • Nalidixic acid (PO) 1000mg 6 hourly for 7 days 

OR 

  • Erythromycin (PO) 250mg 6 hourly for 5 days.

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Updated on, 2.11.2020

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References

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1. STG 

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