MedlinePlus Medical Encyclopedia: Shigella enteritis

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Shigella enteritis

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Digestive system

Digestive system organs

Alternative names Return to top

Shigellosis; Shigella gastroenteritis

Definition Return to top

Shigella enteritis is an acute infection of the lining of the small intestine caused by 1 of 4 different strains of the shigella bacteria.

Causes, incidence, and risk factors Return to top

Outbreaks of shigella enteritis are associated with poor sanitation, inadequate water supplies, contaminated food, crowded living conditions, and fly-infested environments.

Shigella enteritis is common among travelers in developing countries and workers or residents of reservations, refugee camps, and similar institutions. The incubation period is 1 to 7 days, with an average of 3 days.

Although uncommon in adults, neurologic symptoms can develop in children. In up to 40% of children with severe shigella enteritis, febrile seizures, headache, lethargy, confusion, and stiff neck resembling meningitis (nuchal rigidity) can occur.

There are about 18,000 cases of shigella enteritis per year in the US.

Symptoms Return to top

Acute abdominal pain or cramping
Tenesmus (crampy rectal pain)
Watery diarrhea
Nausea and vomiting
Acute fever
Blood, mucus, or pus in stool

Signs and tests Return to top

Dehydration with fast heart rate and low blood pressure
Abdominal tenderness
Elevated white blood cell count
Stool culture
White blood cells in stool

Treatment Return to top

The natural course of the disease is 2-3 days. The objective of treatment is to replace fluids and electrolytes (salt and minerals) lost in diarrhea.

Antidiarrheal medications are generally not given because they may prolong the course of the disease.

Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. Several varieties of electrolyte solutions are now available over the counter.

Antibiotics may be indicated for patients with severe symptoms. Sulfamethoxazole-trimethoprim (Bactrim), ampicillin, ciprofloxacin (Cipro), or chloramphenicol (Chloromycetin) are frequently used.

People with diarrhea who are unable to take fluids by mouth because of nausea may need medical attention and intravenous fluids, especially small children.

People taking diuretics should be cautious if they develop diarrhea, and may be directed by the provider to stop taking the diuretic during the acute episode.

Expectations (prognosis) Return to top

Often the infection is mild and self-limited. Prognosis is excellent except among malnourished and immunocompromised children.

Complications Return to top

Severe dehydration
Neurologic symptoms including seizures (in children)
Hemolytic-uremic syndrome (HUS), a form of kidney failure with anemia and clotting problems
Reiter's syndrome, which involves eye pain and redness, joint pain, and pain with urination

Calling your health care provider Return to top

Call your provider if diarrhea does not improve, if blood is noted in the stool, or if dehydration seems to be developing.

Go to the emergency room if seizures occur, or if confusion, lethargy, headache with stiff neck, or similar symptoms develop in a person with shigella enteritis (most common in children).

Prevention Return to top

Proper handling, storage, and preparation of food, in addition to good sanitation, are principles of prevention for this disease. Hand washing is the most effective preventive measure.

Update Date: 7/8/2004

Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.