Epidemiology
- Shigella is the most common cause of invasive (bloody) diarrhea among children in resource-limited settings.
- Humans are the only natural reservoir for disease.
- Fecal-oral route; this includes transmission within households or between close contacts, transmission through sexual contact, and outbreaks related to contaminated food and water.
Natural history
- Shigella infection is usually self-limited; the average duration of symptoms associated with untreated Shigella gastroenteritis is seven days.
Treatment
- For adults with Shigella infection who are immunocompromised and/or have severe disease (characterized by bacteremia, intestinal or extraintestinal complications, or need for hospitalization), we recommend antibiotic therapy.
- For other symptomatic adults with Shigella infection, we suggest antibiotic therapy.
- We do not give antibiotics to patients with Shigella whose symptoms resolve prior to microbiologic diagnosis in the absence of antibiotic therapy.