Shigella infection - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

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.

Stool exudates in a patient with Shigella infection

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Stool exudates in a patient with Shigella infection

Citations

Key Articles

World Health Organization. Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. 2005 [internet publication].[Full Text]
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.[Abstract][Full Text]
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. [Abstract][Full Text]
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.[Abstract][Full Text]
Murphy MS. Management of bloody diarrhoea in children in primary care. BMJ. 2008 May 3;336(7651):1010-5.[Abstract][Full Text]

Other Online Resources

CDC: national notifiable infectious diseases surveillance system

Referenced Articles

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32. Rabbani GH, Ahmed S, Hossain I, et al. Green banana reduces clinical severity of childhood shigellosis: a double-blind, randomized, controlled clinical trial. Pediatr Infect Dis J. 2009 May;28(5):420-5. [Abstract]
33. European Centre for Disease Prevention and Control. Rapid risk assessment: increase in extensively-drug resistant Shigella sonnei infections in men who have sex with men in the EU/EEA and the UK. Feb 2022 [internet publication].[Full Text]
34. Christopher PR, David KV, John SM, et al. Antibiotic therapy for Shigella dysentery. Cochrane Database Syst Rev. 2010 Aug 4;2010(8):CD006784.[Abstract][Full Text]
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