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

Alternative Names

Shigellosis; Shigella gastroenteritis

Causes, incidence, and risk factors

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.

Signs and tests

Treatment

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 who are severely symptomatic . 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 need to be cautious if they develop diarrhea and may need to stop taking the diuretic during the acute episode, as directed by the health care provider.

Expectations (prognosis)

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

Complications

Calling your health care provider

Call your health care 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

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.