Symptoms and Treatment of Shigella Dysentery

Shigella is a bacterial pathogen that effects the gastrointestinal tract, and you can pick up just about anywhere. Infection results from contact with contaminated feces, and causes severe diarrhea.

Traveler's Diarrhea at Home

Most of us are familiar with the term "traveler's diarrhea", digestive problems that can result from eating contaminated food or water while abroad. But to find a less familiar, more dangerous bacterial pathogen, you may not need to travel any further than your local grocery store.

Shigellosis Case Study

In the summer of 2001, Kim Kelemen, a Kalamazoo, Michigan mother of seven, was tending to three of her brood who had suddenly become violently ill with high fever and diarrhea. The fever didn't go down with medication. The diarrhea showed blood. Kim became frantic.

"When I originally took them to the doctor," explains Kelemen, "they were misdiagnosed and put on an antibiotic that the bacteria was resistant to. After the second round of a different antibiotic (Biaxin), some of the symptoms subsided."

Because the childrens' symptoms did not completely resolve after the second antibiotic, the physician requested stool samples from everyone in the family. That's when the diagnosis was made. Shigellosis. Kim had never heard of it before, and she's not alone.

"The doctor's office called and told me to bring the kids in immediately to start antibiotic injections of Rocefin," Kim recalls. "The treatment was five consecutive days of shots, with the hope that the bacteria were not resistant to this drug as well."

With aggressive antibiotic therapy and lots of fluids, Kelemen's children slowly recovered. After two more uninfected stool samples were examined for each family member, the family was given a clean bill of health. "My kids were the first Health Department-reported Shigella cases of only eleven that year," Kelemen says. "The grossest part was when my doctor told me that this illness could have only resulted from contact with infected feces, and that my kids could have picked this up anywhere: door knobs, shopping carts, even from the fruit at the supermarket."

Shigella Most Severe Gastroenteritis

Shigellosis is more severe than any other form of gastroenteritis. The bacteria multiply in the human gut, where they release a very destructive toxin that causes the typical gastrointestinal symptoms.

Prevalence of Shigellosis

It isn't surprising that Kelemen's children were initially misdiagnosed. There are only about 18,000 cases of shigellosis reported annually in the United States. Although the actual number of infections may be as much as twenty times greater, due to many unreported or misdiagnosed cases.

Bacterial Resistance

As the Kelemen family experienced, many strains of bacteria are becoming resistant to more traditional types of antibiotic therapy. This is due to past overuse and misuse of antibiotics for illnesses that are not due to bacteria. It is a constant "arms race", with modern medicine always trying to find new ways to control bacteria, and new, resistant strains continually developing. Highly effective low-tech precautions include thorough and frequent hand washing, in addition to washing and cooking food.

Shigellosis Facts

* A food-borne illness caused by the bacteria Shigella (a close cousin to E. coli and Salmonella).

* Can be transmitted through food, including salads (potato, tuna, shrimp, macaroni, and chicken), raw vegetables, dairy products, and meat.

* Symptoms range from mild abdominal discomfort to full-blown dysentery with cramps, diarrhea, fever, vomiting, and blood in stools.

* Less-severe cases may last 4 - 8 days without antibiotics. Severe infections may last 3 to 6 weeks.

* Treatment of side effects: Replace fluids and salts lost due to diarrhea. DO NOT use anti-diarrheal drugs. They slow the elimination of Shigella from the gastrointestinal tract, and may prolong the illness.

* Treatment of infection: Severity of the symptoms and length of time the stool contains Shigella bacteria is reduced with antibiotics.

More Information on Shigellosis

You can find more information on infectious disease, Shigellosis and the Shigella bactera at the Center for Disease Control's Shigellosis web page.

This article is a brief summary and case study of shigellosis. The information is not intended for diagnosis or treatment of any type of bacterial gastroenteritis. See your health care practitioner if you are experiencing gastrointestinal health problems.

* This article originally appeared in Suite101 online magazine.