Shigella infection

Last reviewed: 23 Apr 2022
Last updated: 03 Feb 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • diarrhoea
  • cramping abdominal pain
  • fever
  • features of haemolytic uraemic syndrome
More key diagnostic factors

Other diagnostic factors

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

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
More risk factors

Diagnostic investigations

1st investigations to order

  • stool microscopy, culture, and sensitivity
  • serum urea and creatinine
  • FBC
More 1st investigations to order

Investigations to consider

  • Shigella serotyping
  • peripheral blood smear
  • abdominal x-ray
  • flexible sigmoidoscopy
More investigations to consider

Treatment algorithm

ACUTE

suspected or confirmed shigellosis

Contributors

Authors

Ashley Barnabas, MRCP

Consultant Hepatologist and Gastroenterologist

St Mark's and Northwick Park Hospitals

Middlesex

UK

Disclosures

AB declares that he has no competing interests.

Acknowledgements

Dr Ashley Barnabas would like to gratefully acknowledge Dr Satish Keshav, Dr Gehanjali D.A. Amarasinghe, and Dr Richard Pollok, the previous contributors to this topic. Unfortunately, we have been made aware that Dr Satish Keshav has passed away.

Disclosures

GDAA and RP declare that they have no competing interests.

Peer reviewers

David Acheson, MD

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.

Franz Allerberger, MD, MPH

Professor of Clinical Microbiology

Austrian Agency for Health and Food Safety (AGES)

Vienna

Austria

Disclosures

FA declares that he has no competing interests.

  • Shigella infection images
  • Differentials

    • Non-Shigella bacterial diarrhoea
    • Viral gastroenteritis
    • Parasitic diarrhoea
    More Differentials
  • Guidelines

    • CDC health information for international travel (yellow book) - shigellosis
    • Practice guidelines for the diagnosis and management of infectious diarrhea
    More Guidelines
  • Patient leaflets

    Diarrhoea in adults

    Diarrhoea in children

    More Patient leaflets
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