Summary
Shigella are small, ubiquitous gram-negative enterobacteriacea strictly limited to human hosts. The genus is divided into 4 subgroups: S. dysentery, S. flexneri, S. boydii and S. sonnei, all of which cause bacillary dysentery. In France, cases of shigellosis are either imported or limited to small familial epidemics and usually food-borne. They are mostly due to S. sonnei. Shigellas virulence is due to their ability to invade the intestinal epithelium by passing between epithelial contiguous cells, leading to the destruction of the intestinal mucosa. Clinically, after a certain period of incubation (2-3 days), dysenteric syndrome appear, with 10 to 30 glairy, bloody watery stools, high temperature (40°C) and abdominal pain. The intestinal mucosa endoscopy shows multiple ulcerations. S. dysentery also causes neurological signs. Diagnosis is established on the grounds of biological evidence of the bacilli in stools. Treatment is symptomatic, including rehydration, drugs to prevent vomiting, and tension support if needed. Antibiotics (quinolone or cotrimoxasole) have proved to be efficient. Epidemics should be limited by isolating affected individuals. *Author: E. Aslangul, M.D. (Sep.2000)*.
