Shigella Infection

Posted by e-Medical PPT
Shigella Organisms Cause Bacillary Dysentery, A Disease That Has Been Recognized Since The Time Of Hippocrates.
Shigellosis Occurs World-wide. The Incidence In Developing Countries Is 20 Times Greater Than That In Industrialized Countries.
 >95% Of Shigella Infections Are Asymptomatic Hence The Actual Incidence May Be 20 Times Higher Than Is Reported.

The Shigella Bacillus
Shigella Species Are Aerobic, Non-motile, Glucose-fermenting, Gram-negative Rods.
It Is Highly Contagious, Causing Diarrhea After Ingestion Of As A Few As 180 Organisms.
Shigella Spreads By Fecal-oral Contact, Via Contaminated Water Or Food.

4 Species Of Shigella Are Identified, Namely:
 Shigella Dysenteriae
 Shigella Flexneri
 Shigella Sonnei
 Shigella Boydii

Pathology
Gross Pathology Consists Of Mucosal Edema, Erythema, Friability, Superficial Ulcers & Focal Mucosal Hemorrhage Involving The Rectosigmoid Junction Primarily.
Microscopic Pathology Consists Of Epithelial Cell Necrosis, Goblet Cell Depletion, Polymorph & Mononuclear Cell Infiltrates In Lamina Propria And Crypt Abscess Formation

Clinical Picture
Incubation Period Is From 12 To 48 Hours.
Symptoms Begin With Sudden Onset Of High-grade Fever, Abdominal Cramps & Watery Diarrhea
Subsequently The Diarrhea Became Mucoid, Of Small Volume & Mixed With Blood. This Is Accompanied By Abdominal Pain, Tenesmus & Urgency. Fecal Incontinence May Occur.
Physical Signs Are Those Of Dehydration Beside Fever, Lower Abdominal Tenderness & Normal Or Increased Bowel Sounds.

Gastrointestinal Risks
Rectal Prolapse
Toxic Mega Colon
Mild Hepatitis
Septicemia Particularly In Children With Pem

Neurological Complications
These Include:
Lethargy, Delirium, Meningismus & Seizures
Encephalopathy (rare & May Be Lethal)
Syndrome Of Inappropriate Adh Secretion
Febrile Seizures

Systemic Complications
Hemolytic Uremic Syndrome
Disseminated Intravascular Coagulation (dic)
Reiter Syndrome, Arthritis, Conjunctivitis & Urethritis
Myocarditis

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