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Shigella (Intro (50 species, fall into 1 of 4 serological groups (A = S…
Shigella
Intro
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50 species, fall into 1 of 4 serological groups
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invasion via mucosa of colon (enters colonic M cells via pinocytosis, travels cell-cell via actin filaments - helps evade immune system)
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profuse watery diarrhoea, vomiting
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dysentery with bloody mucoid stools, abdo pain, cramps, tenesmus
Complications
intestinal: toxic megacolon, perforation, obstruction
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reactive arthritis: self-limiting, esp in S flexineri infection, up to 2% with HLAB27
HUS: microangiopathic haemolytic anaemia, thrombocytopenia, ARF
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Produces toxins
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Shiga toxin
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bowel ulceration, bloody diarrhoea
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Tx
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antibiotics rarely, other than S dysenteriae
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infected food handlers should be given antibiotics + avoid food prep until stool cultures -ve (usually takes 48hrs of antibiotics)
Stages
early: watery diarrhoea, shiga toxin in SI
late: adherence + invasion of large intestine, dysentery symptoms, cytotoxic activity responsible for severity
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Transmission
faecal oral
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foodborne (unpasteurised milk, raw unwashed veg)
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