Abrupt onset diarrhea with blood and mucous, fever, tenesmus, malaise. Dx and tx.

Abrupt onset diarrhea with blood and mucous, fever, tenesmus, malaise. Dx and tx.

• A. Shigellosis
• B. Salmonellosis
• C. Campylobacteriosis
• D. ETEC

Answer: (A)

Abrupt dysentery with blood and mucus in the stool, fever, tenesmus, and malaise points most strongly to shigellosis. Shigella causes invasion of the colonic mucosa with a strong inflammatory response, which leads to inflammatory diarrhea that often contains blood and mucus and triggers a persistent urge to defecate (tenesmus). The low infectious dose helps explain why transmission is common in households and outbreaks. Dx is made by stool studies that identify Shigella species, with stool leukocytes often present and culture or PCR confirming the organism. Tx centers on fluid and electrolyte repletion to prevent dehydration; antibiotics are used to shorten illness and reduce transmission when indicated. A macrolide such as azithromycin is commonly used, with alternative regimens including a fluoroquinolone like ciprofloxacin depending on local resistance patterns; more severe cases or rapid systemic involvement may require IV antibiotics such as ceftriaxone.

Abrupt dysentery with blood and mucus in the stool, fever, tenesmus, and malaise points most strongly to shigellosis. Shigella causes invasion of the colonic mucosa with a strong inflammatory response, which leads to inflammatory diarrhea that often contains blood and mucus and triggers a persistent urge to defecate (tenesmus). The low infectious dose helps explain why transmission is common in households and outbreaks.

Dx is made by stool studies that identify Shigella species, with stool leukocytes often present and culture or PCR confirming the organism.

Tx centers on fluid and electrolyte repletion to prevent dehydration; antibiotics are used to shorten illness and reduce transmission when indicated. A macrolide such as azithromycin is commonly used, with alternative regimens including a fluoroquinolone like ciprofloxacin depending on local resistance patterns; more severe cases or rapid systemic involvement may require IV antibiotics such as ceftriaxone.