| Fact | Explanation |
|---|---|
| Acute onset blood and mucus diarrhoea. | Shigella is an invasive enteropathogen which causes a mucosal inflammatory response in the intestine which usually involves the release of cytolethal cytotoxins resulting in epithelial cell loss and ulceration [1]. |
| Cramping type abdominal pain. | It is associated with acute inflammation of the intestinal mucosal wall [2]. |
| Tenesmus. | As a result of proctitis [3]. |
| Fever. | It occurs as part of the acute inflammatory response to infection of the colon [4]. |
| Vomiting. | Damage of the gut mucosa triggers the release of serotonin from enterochromaffin cells which acts on 5-HT receptors which in turn mediates vomiting [5]. |
| Symptoms usually last 5-7 days. | Bacillary dysentery diarrhoea is usually a self-limiting condition [6]. |
| Fact | Explanation |
|---|---|
| Lower abdominal tenderness. | Due to inflammation of the colonic wall [1]. |
| Dry and sunken eyes, dry mouth, reduced skin turgor and other features of dehydration. | Due to the associated fluid loss as a result of the diarrhoea [2]. |
| Pyrexia. | It occurs as part of the acute inflammatory response to infection of the colon [3]. |
| Fact | Explanation |
|---|---|
| Viral gastroenteritis. | it presents as watery, non-bloody diarrhoea [1]. |
| Crohn's disease. | It presents with frequent relapses [2]. |
| Amebiasis | Since it is of gradual onset, weight loss is a common feature. Bleeding without diarrhoea is also common [3]. |
| Salmonellosis. | The blood which is associated with diarrhoea is less than that of shigellosis [4]. |
| Campylobacter enteritis. | Vomiting is rare and abdominal pain and discomfort which is severe may persist even after the diarrhoea has stopped [5]. |
| Cholera. | It presents with massive watery diarrhoea of great volume and can present with features of hypotension within 12 hours of onset of symptoms [6]. |
| Fact | Explanation |
|---|---|
| Stool full report revealing red blood cells and leukocytes. | Shigella is an invasive enteropathogen which causes a mucosal inflammatory response in the intestine which usually involves the release of cytolethal cytotoxins resulting in epithelial cell loss and ulceration [1]. |
| Positive findings in stool culture. | The infected individual excretes the organism in stools [2]. |
| Elevated hematocrit in full blood count. | As a result of the intravascular fluid depletion due to diarrhoea [3]. |
| Fact | Explanation |
|---|---|
| Renal function tests such as serum electrolytes and blood urea levels. | To look for evidence of renal compromise so that complications such as pulmonary edema can be prevented during fluid resuscitation by maintaining the appropriate fluid requirement [1]. |
| Fact | Explanation |
|---|---|
| It is mainly supportive with fluids and antipyretics. | Shigellosis is a self-limiting condition [1]. |
| Antipyretics. Eg: Paracetomol 10-15mg/kg/dose 6 hourly. | Fever occurs as part of the acute inflammatory response [2]. |
| Oral rehydration sloutions. Mild dehydration: 50 ml/kg over 4 hours moderate dehydration: 100ml/kg over 4 hours. | To compensate for the fluid and electrolyte losses associated with diarrhoea [3]. |
| Avoid antimotility drugs. | They are known to cause prolonged fever in those with shigellosis [4]. |
| Fact | Explanation |
|---|---|
| Ciprofloxacin. 20mg/kg twice daily. | Antimicrobial therapy shortens the average duration of diarrhoea, decreases the duration of fever and tenesmus, and reduces the excretion of infectious organisms [1]. |
| Nalidixic acid. 55mg/kg/day for 5 days. | Antimicrobial therapy shortens the average duration of diarrhoea, decreases the duration of fever and tenesmus, and reduces the excretion of infectious organisms [1]. |
| Trimethoprim and sulfamethoxazole. 5mg/kg and 25 mg/kg respectively, twice a day for 3 days. | Antimicrobial therapy shortens the average duration of diarrhoea, decreases the duration of fever and tenesmus, and reduces the excretion of infectious organisms [1]. |
| Antibiotic treatment should be used mainly for immunocompromised patients and malnourished children. | Therapy with broad-spectrum antibiotics may facilitate the emergence of drug resistance among bacterial enteric pathogens that spread easily from person to person, such as Shigella [2]. |