Shigellosis

Shigellosis is a bacterial infection leading to dysentery and is caused by Shigella, which are small, ubiquitous Gram-negative bacteria belonging to the enterobacteria family. There are four species: S. dysenteriae, S. flexneri, S. boydii and S. sonnei, all of which cause bacillary dysentery and are strictly limited to human hosts.

Clinical description

Clinically, after an incubation period of 2-3 days, dysenteric syndrome appears, with 10-30 glairy, bloody watery stools per day, a high temperature (40°C) and abdominal pain. Examination of the intestinal mucosa with endoscopy shows multiple ulcerations.

Etiology

In western Europe, cases of shigellosis are either imported or limited to small familial epidemics and usually food-borne. They are mostly due to S. sonnei. The virulence of shigellas is a result of their ability to invade the intestinal epithelium by passing between contiguous epithelial cells, leading to the destruction of the intestinal mucosa.

Diagnostic methods

Diagnosis is based on evidence of the bacilli in stools.

Management and treatment

Treatment revolves around administration of antibiotics, quinolones and cotrimoxazole, and rehydration to alleviate symptoms. Strict isolation of affected individuals is essential to limit epidemics. The disease is notifiable