eMedicine Specialties > Gastroenterology > Colon
Shigellosis: Differential Diagnoses & Workup
Updated: Aug 22, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Workup
Laboratory Studies
- Fecal leukocytes and erythrocytes
- Mildly elevated hematocrit, sodium, and urea nitrogen are indicative of volume depletion in cases of shigellosis.
- Leukocytosis is rare.
- Positive findings on stool culture of a fresh fecal specimen
- In patients who are immunocompromised (eg, HIV), blood cultures are rarely helpful in cases of shigellosis.
Procedures
- Sigmoidoscopy is not necessary in most cases of shigellosis.
- If distinguishing between dysentery and the acute presentation of idiopathic ulcerative colitis is urgently necessary, a colonic biopsy may be useful if it is performed within 4 days of the onset of symptoms.
Histologic Findings
- Intense neutrophilic and mononuclear cells infiltrating the lamina propria
- Hemorrhage
- Ulcers
- Mucous depletion
- Occasional crypt abscesses
More on Shigellosis |
| Overview: Shigellosis |
Differential Diagnoses & Workup: Shigellosis |
| Treatment & Medication: Shigellosis |
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References
Al-Abri SS, Beeching NJ, Nye FJ. Traveller's diarrhoea. Lancet Infect Dis. Jun 2005;5(6):349-60. [Medline].
Banerjee S, LaMont JT. Treatment of gastrointestinal infections. Gastroenterology. Feb 2000;118(2 Suppl 1):S48-67. [Medline].
Dupont HL, Edelman R, Kimmey M. Infectious diarrhea: from E coli to Vibrio. Patient Care. 1990;30:18-43.
Kroser JA, Metz DC. Evaluation of the adult patient with diarrhea. Prim Care. Sep 1996;23(3):629-47. [Medline].
Murphy GS, Bodhidatta L, Echeverria P, et al. Ciprofloxacin and loperamide in the treatment of bacillary dysentery. Ann Intern Med. Apr 15 1993;118(8):582-6. [Medline].
Policar M. Shigellosis. In: Ferri's Clinical Advisor: Instant Diagnosis and Treatment. 2005:752-754.
Sivapalasingam S, Nelson JM, Joyce K, et al. High prevalence of antimicrobial resistance among Shigella isolates in the United States tested by the National Antimicrobial Resistance Monitoring System from 1999 to 2002. Antimicrob Agents Chemother. Jan 2006;50(1):49-54. [Medline].
Taneja N. Changing epidemiology of shigellosis and emergence of ciprofloxacin-resistant Shigellae in India. J Clin Microbiol. Feb 2007;45(2):678-9. [Medline].
Wolf DC, Gianella RA. Invasive pathogens. Consultations in Gastroenterology. 1996;381-384.
Further Reading
Keywords
shigellosis, dysentery, bacillary dysentery, diarrhea, bacterial infection, intestinal infection, Shigella organisms, Shigella boydii, Shigella dysenteriae, Shigella sonnei, Shigella flexneri, S dysenteriae, S flexneri, S sonnei, S boydii
Differential Diagnoses & Workup: Shigellosis