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
Investigations to consider
- Shigella serotyping
- peripheral blood smear
- abdominal x-ray
- flexible sigmoidoscopy
Treatment algorithm
Contributors
Authors
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
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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