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Shigella infection

最后审阅: 19 Aug 2025
最后更新: 30 Jan 2024

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
完整详情

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
完整详情

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
完整详情

诊断性检查

首要检查

  • stool microscopy, culture, and sensitivity
  • serum BUN and creatinine
  • CBC
完整详情

需考虑的检查

  • Shigella serotyping
  • peripheral blood smear
  • abdominal x-ray
  • flexible sigmoidoscopy
完整详情

治疗流程

急症处理

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
  • Shigella infection images
  • 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

    更多 患者教育信息
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