Shigellosis also known as bacillary dysentery or Marlow syndrome, in its most severe manifestation, is a food borne illness caused by infection by bacteria of the genus shigella.
Shigella species such as shigella dysenteriae, shigella flexeri, shigella sonnei, shigella boydii are aerobic, non motile, glucose-fermenting, gram-negative rods that are highly contagious, causing diarrhea after ingestion of a few as 180 organsims.
Shigella species causes damage to human body by 2 mechansims, as follows:
Invasion of the colonic epithelium which is dependent on a plasmid-mediated virulence factor
>Production of enterotoxin which is not essential for colitis but enhances virulence.
The organism is spread by fecal-oral contact via infected food and water, during travel or in long-term care facilities, day care centers or nursing homes.[/expand]Age/sex prevalence of Shigellosis /Bacillary dysentery/Marlow syndrome
Shigella can affect individuals at any age. Shigellosis is most common in children aged 6 months to 5 years.
No sexual predilections exist in shigella infections.
Shigellosis can occur in individuals of any race.
Causes of Shigellosis /Bacillary dysentery/Marlow syndrome
The major causative organisms for shigellosis are as follows
• S. sonnei and S flexneri are cause of shigellosis in 90% of cases.
• S dysenteriae has produced epidemic shigellosis.
Symptoms presented by patients of shigellosis are as follows
• Mild abdominal discomfort.
• Full blown dysentery characterized by
Mucus in stools
• Lower abdominal tenderness
• Lower abdominal bowel sounds
• Infection of shigellosis is usually associated with
Hemolytic uremic syndrome
Laboratory tests to be done are as follows
• Fecal leukocytes and erythrocytes
• Mildly elevated hematocrit
• Serum sodium
• Urea nitrogen
• Positive findings on stool culture of fresh fecal specimen
• Blood cultures
Histologic findings are as follows
• Mucous depletion
• Occasional crypt abscesses
Treatment can be done on following basis
• Replacing fluids and salt lost because of diarrhea
• Oral replacement
• Antimotility agents should be avoided
Chronic carriers of shigellosis are unusual
Prognosis of Shigellosis /Bacillary dysentery/Marlow syndrome
Postinfection carriage is generally less than 3-4 weeks.
Mild cramps and diarrhea may continue for many days to weeks after treatment of shigellosis.
• Viral gastroenteritis
• Bacterial gastroenteritis
• Ulcerative colitis
• Yersinia enterocolitica
• Clostridium difficile colitis
• Colon cancer
• Crohn disease
• Pseudomembranous colitis
• Campylobacter infections
• Escherichia coli infections
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