Shigella infection

Shigella infection is easily spread by fecal-oral contact or by contaminated water or food. It usually presents as a mild, self-limited diarrheal illness.

Shigella dysenteriae is more common in low- and middle-income countries and causes a more severe illness with dysentery. S dysenteriae type 1 is a cause of hemolytic uremic syndrome owing to its production of Shiga toxin.

Treatment is usually supportive in mild cases, although antibiotics may be useful to shorten the course of the illness and reduce shedding of the organism in stool, particularly in patients with bloody diarrhea.

Empiric antibiotics are recommended for children and adults with severe disease, for older adults, for malnourished or chronically ill patients, and to reduce spread (e.g., in institutions).

Prevention is paramount, including basic hygiene measures such as hand-washing with soap, access to clean water, and cooking, especially in institutions and camps during natural disasters. Vaccinations are in developmental stages.

​Shigellosis is an important cause of diarrheal disease worldwide, most commonly affecting children age <5 years.​[1]Khalil IA, Troeger C, Blacker BF, et al. Morbidity and mortality due to shigella and enterotoxigenic Escherichia coli diarrhoea: the Global Burden of Disease Study 1990-2016. Lancet Infect Dis. 2018 Nov;18(11):1229-40. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30475-4/fulltext http://www.ncbi.nlm.nih.gov/pubmed/30266330?tool=bestpractice.com ​​​​​​​ Shigella is a genus of the Enterobacteriaceae family, consisting of four species of aerobic, nonmotile, non-lactose-fermenting gram-negative rods: S sonnei, S flexneri, S boydii, and S dysenteriae.[2]Centers for Disease Control and Prevention. ​Shigella - shigellosis: clinical overview of shigellosis. Mar 2024 [internet publication]. https://www.cdc.gov/shigella/hcp/clinical-overview/index.html

Shigellosis may spread from person to person (by fecal-oral contact), and via contaminated water and food. Outbreaks occur in institutions and in overcrowded areas where sanitation is poor. Although not equivalent, the term "bloody diarrhea" is sometimes used interchangeably by clinical practitioners.