小结
定义
病史和体格检查
关键诊断因素
- diarrhea
- cramping abdominal pain
- fever
- tenesmus
- abdominal pain or tenderness
- features of hemolytic uremic syndrome
其他诊断因素
- signs of volume depletion
- increased bowel sounds
- vomiting
- meningismus or other signs of altered neurologic status
- febrile seizures
- somnolence
危险因素
- exposure to contaminated water or food or direct fecal-oral contact
- age <5 years
- malnutrition
- poor hygiene and cramped conditions
- travel to endemic areas
- men who have sex with men
诊断性检查
首要检查
- stool microscopy, culture, and sensitivity
- serum BUN and creatinine
- CBC
需考虑的检查
- Shigella serotyping
- peripheral blood smear
- abdominal x-ray
- flexible sigmoidoscopy
治疗流程
suspected or confirmed shigellosis
撰稿人
作者
Ashley Barnabas, MRCP
Consultant Hepatologist and Gastroenterologist
St Mark's and Northwick Park Hospitals
Middlesex
UK
利益声明
AB declares that he has no competing interests.
鸣谢
Dr Ashley Barnabas would like to gratefully acknowledge Dr Gehanjali D.A. Amarasinghe, Dr Richard Pollok, and the late Dr Satish Keshav, the previous contributors to this topic.
利益声明
GDAA and RP declare that they have no competing interests.
同行评议者
David Acheson, MD
Chief Medical Officer
Director of Food Safety and Security
US Food and Drug Administration
Rockville
MD
利益声明
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
利益声明
FA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
World Health Organization. Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. 2005 [internet publication].全文
King CK, Glass R, Bresee JS, et al. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003 Nov 21;52(RR-16):1-16.全文 摘要
Riddle MS, DuPont HL, Connor BA. ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016 May;111(5):602-22.全文 摘要
Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-80.全文 摘要
Murphy MS. Management of bloody diarrhoea in children in primary care. BMJ. 2008 May 3;336(7651):1010-5.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Non-Shigella bacterial diarrhea
- Viral gastroenteritis
- Parasitic diarrhea
更多 鉴别诊断指南
- CDC Yellow Book: health information for international travel - shigellosis
- WHO model list of essential medicines for children - 9th list, 2023
更多 指南患者教育信息
Diarrhea in adults
Diarrhea in children
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