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Shigellosis 

Shigellosis
Chapter:
Shigellosis
DOI:
10.1093/med/9780198729228.003.0113
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date: 08 December 2019

Shigellosis, also called bacillary dysentery, is caused by four species: Shigella dysenteriae, Shigella flexneri, Shigella boydii, and Shigella sonnei. Humans are the only significant reservoir of Shigella infection. S. sonnei is endemic in Europe, while S. flexneri is the prevalent species in developing countries. Peak incidence is in children 1–4 years of age. The infective dose is very low, with direct person-to-person spread through the faecal–oral route in young children being commonest in households, schools, and nurseries. The illness varies from mild watery diarrhoea to abdominal pain with severe diarrhoea with blood or mucus. Dehydration and electrolyte imbalance are the commonest complications, especially in very young children. Invasive disease is rare, but extraintestinal complications, such as haemolytic–uraemic syndrome, can occur. The mainstay of treatment is replacement of fluid and electrolyte losses, and antibiotic treatment. Preventative measures include good hand hygiene and appropriate sanitation.

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