Shigella infection

Q: Which tends to be more common in Shigella infection? (select one)

A) Mucoid diarrhea

B) Watery diarrhea 

Answer: A

Shigella tends to affect the rectosigmoid portion of the colon. Shigella gastroenteritis is marked by high fever, abdominal cramps, tenesmus, and blood-stained mucoid diarrhea with frequent daily episodes. In terms of frequency, the following occurs in descending order:

Mucoid diarrhea – 70 to 85 percent

Blood-stained diarrhea – 35 to 55 percent

Watery diarrhea – 30 to 40 percent

Though diarrhea starts as watery but quickly turns into blood and mucus mixed. Tenesmus is a common complaint. This is more common with Shigella dysenteriae 1 or Shigella flexneri.

In contrast, large volumes of watery diarrhea with abdominal cramping, bloating, and gas usually occurs due to small bowel infections.

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References:

1. Khan WA, Griffiths JK, Bennish ML. Gastrointestinal and extra-intestinal manifestations of childhood shigellosis in a region where all four species of Shigella are endemic. PLoS One 2013; 8:e64097.

2. Zaidi MB, Estrada-García T. Shigella: A Highly Virulent and Elusive Pathogen. Curr Trop Med Rep. 2014 Jun 1;1(2):81-87. doi: 10.1007/s40475-014-0019-6. PMID: 25110633; PMCID: PMC4126259.

3. Niyogi SK. Shigellosis. J Microbiol. 2005 Apr;43(2):133-43. PMID: 15880088.