Shigella infection is an acute intestinal infection, caused by the shigella family of bacteria, which is one of the main causes of gastritis and bacillary dysentery. Most people with bacterial infections recover on their own, but people who are seriously ill or immunocompromised may need antibiotics for treatment.
Learn general
What is Shigella infection?
Shigella infection is an intestinal infection that causes diarrhea and is highly contagious.
Symptom
Signs and symptoms of shigella infection
The incubation period ranges from 12 to 96 hours, meaning the disease usually begins 12 to 96 hours after shigella bacteria enter the body.
Symptoms of shigellosis include:
- Diarrhea may contain blood;
- Fever ;
- Stomach-ache;
- Feeling like you need to have a bowel movement even when your bowels are empty.
Some people will not have any symptoms.
Symptoms usually last 5 to 7 days, but some people may experience symptoms for several days to 4 weeks or more. In some cases, it may take up to several months for bowel habits (e.g., frequency of bowel movements and stool consistency) to return to completely normal.
With more severe shigellosis, patients may experience diarrhea so severe that they become dehydrated. Occasionally, shigellosis causes seizures, sepsis, or arthritis, and rarely leads to death.
In young children, sudden onset of fever, irritability or drowsiness, loss of appetite, nausea or vomiting, diarrhea, abdominal pain, bloating, and tenesmus. Within 3 days, blood, pus and fluid appear in the stool. The number of stools may increase to ≥ 20 times/day, weight loss and dehydration become severe. If not treated, children can die within the first 12 days. If the child survives, acute symptoms should subside by week 2.
Complications can occur when infected with shigella
Reactive arthritis: About 2% of people infected with certain types of Shigella , most commonly Shigella flexneri, will develop reactive arthritis after infection, which can cause joint pain, eye irritation, and pain during urination. It usually lasts 3 to 5 months, but sometimes it can last for years and lead to chronic arthritis.
Sepsis: About 0.4% to 7.3% of people infected with Shigella develop sepsis, most commonly in immunocompromised patients such as those with HIV, diabetes, cancer, or heart failure. severe malnutrition, and is often seen in children, especially in children under 5 years old and in adults over 65 years old.
Hemolytic-uremic syndrome: A rare complication of Shigella infection, it also occurs most often in children. Occurs when bacteria enter the digestive system and produce a toxin that destroys red blood cells, blocks the kidney’s filtering function and can lead to kidney failure. Patients often have bloody diarrhea and can lead to death.
Severe mucosal ulcers can cause acute significant blood loss.
Other complications are uncommon but include epilepsy in children, myocarditis and, more rarely, intestinal perforation.
When to see a doctor?
People with diarrhea should contact their doctor if they have any of the following symptoms:
- Fever;
- bloody diarrhea;
- Severe cramping or abdominal pain;
- Dehydration.
People who are in poor health or have immune systems weakened by disease (such as HIV) or undergoing medical treatment (such as cancer chemotherapy) are more likely to be ill for a longer period of time. Contact your doctor if you belong to one of these groups and have symptoms of a Shigella infection.
Reason
Causes of shigella infection
The genus Shigella is present worldwide and is the main cause of dysentery, causing 5 to 10% of diarrhea in many regions. Shigella is divided into 4 main subgroups:
- A ( S. dysenteriae )
- B ( S. flexneri )
- C (S. boydii)
- D ( S. sonnei )
The source of infection is the feces of an infected person or carrier of the bacteria; Humans are the only natural reservoir for Shigella . Direct spread is by the fecal-oral route. Indirect transmission through contaminated food and containers containing bacteria. Flies are vectors of disease transmission.
People can become infected with Shigella from:
- Get Shigella germs on your hands and then touch food or your mouth. For example: Changing diapers for sick children or taking care of sick people; touching surfaces contaminated with germs from an infected person’s stool. Surfaces include diaper pails, changing tables, bathroom fixtures, toys, etc.
- Eat food prepared by someone infected with Shigella .
- Foods that are eaten raw are more likely to be contaminated with Shigella bacteria .
- Shigella germs can also get into fruits and vegetables if the fields where they are grown are contaminated with manure containing the germs.
- Swallowing water (for example, lake or river water) while swimming or drinking water contaminated with feces containing germs.
- Contact with feces during sex with an infected person.
Convalescent carriers or patients without clinical symptoms can be a significant source of infection; true long-term carriers are rare.
An episode of shigella induces serospecific immunity for at least several years. But patients may have additional episodes of shigellosis due to infection with other types of shigellosis.
Risk
Who is at risk of getting shigellosis?
Shigella infection is most common in young children. Children can become infected if they put unwashed hands in their mouths after touching something contaminated with Shigella.
Travelers to countries without treated tap water or inadequate sanitation.
Gay men have homosexual relations.
Factors that increase the risk of getting shigella infection
Some factors increase the risk of shigella, including:
- Not performing proper personal hygiene regularly.
- Traveling.
Diagnosis & Treatment Methods
Methods of testing and diagnosing shigella infection
Diagnostic methods: Stool culture, bacterial isolation or rapid diagnostic test to detect bacterial genetic material.
Effective treatment for shigellosis
People with mild illness often recover on their own, without needing specific treatment.
Treatments:
- Supportive care, hydration and electrolyte replacement.
- For severe or at-risk patients, use antibiotics to treat bacterial infections, such as fluoroquinolones, azithromycin, or third-generation cephalosporins.
Antibiotics can relieve symptoms and reduce Shigella but are not necessary for healthy adults with mild illness. However, certain patients require antibiotic treatment such as:
- Children;
- Elderly;
- The patient is exhausted;
- Patients have moderate to severe disease.
For adults, the following antibiotic regimens may be used:
- Fluoroquinolone (as ciprofloxacin 500 mg orally every 12 hours for 3 to 5 days).
- Azithromycin 500 mg orally on day 1 and 250 mg once/day for the next 4 days.
- Ceftriaxone 2 g/day IV for 5 days.
For children, the following antibiotic regimens may be used:
- Ceftriaxone 50 mg/kg (maximum 1.5 g) administered intravenously once daily for 5 days.
- Azithromycin 10 to 12 mg/kg PO once on day 1, followed by 6 mg/kg (maximum 250 mg) PO once/day for the next 4 days.
Note: When using medications, you must follow your doctor’s instructions.
Lifestyle & Prevention
Living habits can help you limit the progression of shigella infection
Living mode:
- Follow your doctor’s instructions for treatment.
- Contact your doctor immediately if your body experiences abnormalities during treatment.
- Visit regularly to monitor your health status, disease progression and for your doctor to find appropriate treatment in the future if the disease shows no signs of improvement.
- Patients need to be optimistic, psychology has a great influence on treatment, talk to trusted people, share with family members, keep pets or simply read books, do anything. whatever makes you feel comfortable.
Nutrition:
- You should drink plenty of water to avoid dehydration.
- You should cook food thoroughly before eating, and limit eating raw and unprocessed foods.
- You need to choose foods that are bland, easy to digest, and not greasy.
- Each meal should not be too full, divided into several meals.
Effective method of preventing shigellosis
To effectively prevent the disease, you can refer to some suggestions below:
- Hands must be washed before preparing or eating food. Clothes and bedding should be soaked in a bucket of soap, water and disinfectant then washed in hot water. Appropriate isolation techniques (especially fecal isolation) should be used with patients and carriers.
- During sex, avoid unprotected oral-anal contact and be sure to wash your hands, other parts of your body, and any objects after sex.
- When traveling to developing countries where Shigella infection is common: Drink only treated or boiled water, and eat only hot cooked foods or peeled fruits/vegetables after thorough washing.
- Oral live bacterial vaccines are still being tested.
