Digestive system
Digestive system
Digestive system organs
Digestive system organs

Shigella enteritis

Shigella enteritis is an acute infection of the lining of the small intestine caused by 1 of 4 different strains of the shigella bacteria,

Alternative Names:
Shigellosis; Shigella gastroenteritis

Causes, incidence, and risk factors:

Outbreaks of shigella enteritis are associated with poor sanitation, inadequate water supplies, contaminated food, crowded living conditions, and fly-infested environments.

Shigella enteritis is common among travelers in developing countries and workers or residents of reservations, refugee camps, and similar institutions. The incubation period is 1 to 7 days, with an average of 3 days.

Although uncommon in adults, neurologic symptoms can develop in children. In up to 40% of children with severe shigella enteritis, febrile seizures, headache, lethargy, confusion, and stiff neck resembling meningitis (nuchal rigidity) can occur.

There are about 18,000 cases of shigella enteritis per year in the US.

Signs and tests:
  • Fast heart rate and low blood pressure if dehydration develops
  • Abdominal tenderness
  • Elevated white blood cell count
  • Stool culture
  • White blood cells in stool
The natural course of the disease is 2-3 days. The objective of treatment is to replace fluids and electrolytes (salt and minerals) lost in diarrhea.

Antidiarrheal medications are generally not given because they may prolong the course of the disease.

Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. Several varieties of electrolyte solutions are now available over the counter.

Antibiotics may be indicated for patients who are severely symptomatic. Sulfamethoxazole-trimethoprim (Bactrim), ampicillin, ciprofloxacin (Cipro), or chloramphenicol (Chloromycetin) are frequently used.

People with diarrhea who are unable to take fluids by mouth because of nausea may need medical attention and intravenous fluids, especially small children.

People taking diuretics need to be cautious if they develop diarrhea and may need to stop taking the diuretic during the acute episode, as directed by the health care provider.
Expectations (prognosis):
Often the infection is mild and self-limited. Prognosis is excellent except among malnourished and immunocompromised children.
  • Severe dehydration
  • Neurologic symptoms including seizures (in children)
  • Hemolytic-uremic syndrome (HUS), a form of kidney failure with anemia and clotting problems
  • Reiter's syndrome, which involves eye pain and redness, joint pain, and pain with urination
Calling your health care provider:
Call your health care provider if diarrhea does not improve, if blood is noted in the stool, or if dehydration seems to be developing.

Go to the emergency room if seizures occur, or if confusion, lethargy, headache with stiff neck, or similar symptoms develop in a person with shigella enteritis (most common in children).
Proper handling, storage, and preparation of food, in addition to good sanitation, are principles of prevention for this disease. Hand washing is the most effective preventive measure.

Review Date: 7/31/2002
Reviewed By: Christopher Parsons, M.D., Department of Internal Medicine, Division of Infectious Diseases, University of Virginia, Charlottesville, VA. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.