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Shigellosis Workup

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Shigellosis Workup
Author: Joyann A Kroser, MD, FACP, FACG, AGAF; Chief Editor: Julian Katz, MD more... Updated: May 23, 2013

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

Contributor Information and Disclosures

Author Joyann A Kroser, MD, FACP, FACG, AGAF Adjunct Clinical Associate Professor of Medicine, Gastroenterology, and Hepatology, Drexel University College of Medicine Joyann A Kroser, MD, FACP, FACG, AGAF is a member of the following medical societies: Alpha Omega Alpha, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Medical Association, American Society for Gastrointestinal Endoscopy, Crohns and Colitis Foundation of America, Pennsylvania Medical Society, Phi Beta Kappa, and Philadelphia County Medical Society Disclosure: Nothing to disclose. Specialty Editor Board Ronnie Fass, MD, FACP, FACG Chief of Gastroenterology, Head of Neuroenteric Clinical Research Group, Southern Arizona Veterans Affairs Health Care System; Professor of Medicine, Division of Gastroenterology, University of Arizona School of Medicine Ronnie Fass, MD, FACP, FACG is a member of the following medical societies: American College of
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Shigellosis Workup

Gastroenterology, American College of Physicians-American Society of Internal Medicine, American Gastroenterological Association, American Motility Society, American Society for Gastrointestinal Endoscopy, and Israel Medical Association Disclosure: Takeda Pharmaceuticals Grant/research funds Conducting research; Takeda Pharmaceuticals Consulting fee Consulting; Takeda Pharmaceuticals Honoraria Speaking and teaching; Vecta Consulting fee Consulting; XenoPort Consulting fee Consulting; Eisai Honoraria Speaking and teaching; Wyeth Pharmaceuticals Conducting research; AstraZeneca Grant/research funds Conducting research; Eisai Consulting fee Consulting Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Medscape Salary Employment Aaron Glatt, MD Chief Administrative Officer, Executive Vice President, Mercy Medical Center, Catholic Health Services of Long Island Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physician Executives, American College of Physicians, American College of PhysiciansAmerican Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, and Society for Healthcare Epidemiology of America Disclosure: Nothing to disclose. Alex J Mechaber, MD, FACP Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine Disclosure: Nothing to disclose. Chief Editor Julian Katz, MD Clinical Professor of Medicine, Drexel University College of Medicine Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility Disclosure: Nothing to disclose.

References
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Shigellosis Workup

6. Banerjee S, LaMont JT. Treatment of gastrointestinal infections. Gastroenterology. Feb 2000;118(2 Suppl 1):S48-67. [Medline]. 7. 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]. 8. Wolf DC, Gianella RA. Invasive pathogens. Consultations in Gastroenterology. 1996;381-384. 9. 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]. 10. Vinh H, Anh VT, Anh ND, Campbell JI, Hoang NV, Nga TV, et al. A multi-center randomized trial to assess the efficacy of gatifloxacin versus ciprofloxacin for the treatment of shigellosis in Vietnamese children. PLoS Negl Trop Dis . Aug 2011;5(8):e1264. [Medline]. [Full Text]. 11. Policar M. Shigellosis. In: Ferri's Clinical Advisor: Instant Diagnosis and Treatment. 2005:752-754. 12. Gu B, Ke X, Pan S, Cao Y, Zhuang L, Yu R, et al. Prevalence and trends of aminoglycoside resistance in Shigella worldwide, 1999-2010. J Biomed Res . Mar 2013;27(2):103-15. [Medline]. [Full Text]. 13. Taneja N. Changing epidemiology of shigellosis and emergence of ciprofloxacin-resistant Shigellae in India. J Clin Microbiol. Feb 2007;45(2):678-9. [Medline]. Medscape Reference 2011 WebMD, LLC

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