Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • diarrhoea
  • cramping abdominal pain
  • fever
  • features of haemolytic-uraemic syndrome

Other diagnostic factors

  • tenesmus
  • abdominal pain or tenderness
  • signs of volume depletion
  • increased bowel sounds
  • vomiting
  • meningism
  • febrile seizures
  • delirium or somnolence

Risk factors

  • exposure to contaminated water or food or direct faecal-oral contact
  • age <5 years
  • age >50 years
  • malnutrition
  • poor hygiene and cramped conditions
  • chronic illness or immunocompromise
  • travel to endemic areas
  • men who have sex with men

Diagnostic investigations

1st investigations to order

  • stool microscopy, culture, and sensitivity
  • serum urea and creatinine
  • FBC
Full details

Investigations to consider

  • Shigella serotyping
  • peripheral blood smear
  • abdominal x-ray
  • flexible sigmoidoscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Gastroenterologist

Department of Gastroenterology

John Radcliffe Hospital

Oxford

UK

Disclosures

SK declares that he has no competing interests.

Consultant Hepatologist and Gastroenterologist

St Mark's and Northwick Park Hospitals

Middlesex

UK

Disclosures

AB declares that he has no competing interests.

Dr Satish Keshav and Dr Ashley Barnabas would like to gratefully acknowledge Dr Gehanjali D.A. Amarasinghe and Dr Richard Pollok, the previous contributors to this monograph. GDAA and RP declare that they have no competing interests.

Peer reviewers VIEW ALL

Chief Medical Officer

Director of Food Safety and Security

US Food and Drug Administration

Rockville

MD

Disclosures

DA declares that he has no competing interests.

Professor of Clinical Microbiology

Austrian Agency for Health and Food Safety (AGES)

Vienna

Austria

Disclosures

FA declares that he has no competing interests.

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