Diagnosis

Diagnosis of shigella infection involves a physical exam and testing to find out if you have the illness. Many other health conditions can cause diarrhea or bloody diarrhea.

You or your healthcare professional collects a sample of your stool. Then a lab checks the sample for shigella germs or for harmful substances called toxins that the germs make.

Treatment

Treatment for shigella infection depends on how serious the illness is. Most often, the illness is mild and gets better within seven days. You may only need to replace lost fluids from diarrhea, especially if your overall health is good.

Medicines sold without a prescription

Talk to your healthcare professional before you take any diarrhea medicine that's sold without a prescription. Many conditions can cause diarrhea, and these medicines could make some conditions worse.

If a lab test has confirmed that you have shigella infection, medicine that contains bismuth subsalicylate (Pepto-Bismol, Kaopectate) may help. This is available without a prescription. It may help you pass stool less often and shorten the length of your illness. But it isn't recommended for children, pregnant or breastfeeding people, or people who are allergic to aspirin.

Do not take diarrhea medicines such as loperamide (Imodium A-D). Also, do not take medicines that contain the combination of diphenoxylate and atropine (Lomotil). These aren't recommended for shigella infection. They can lower the body's ability to clear shigella germs and make your condition worse.

Antibiotics

For a serious shigella infection, your healthcare professional may recommend medicines called antibiotics that help get rid of germs. Antibiotics may shorten the length of the illness. But some shigella bacteria resist the effects of these medicines. So your healthcare professional may not recommend antibiotics unless your shigella infection is very bad.

Antibiotics also may be needed to treat infants, older adults and people with weakened immune systems. Antibiotics also may be used if there's a high risk of spreading the disease.

If you're given antibiotics, take them exactly as prescribed. Finish taking all the pills even if you start to feel better.

Fluid and salt replacement

For adults in good health overall, drinking water may be enough to prevent dehydration caused by diarrhea.

Children may benefit from a treatment called oral rehydration solution, such as Pedialyte. This is sold in drugstores and taken by mouth. Many pharmacies carry their own brands.

Children and adults who are very dehydrated need treatment in a hospital emergency room. Treatment involves salts and fluids given through a vein rather than by mouth. This is called intravenous hydration. It provides the body with water and essential nutrients much more quickly than oral solutions do.

Preparing for your appointment

Many people who have shigella infection get better without medicines. But if you or your child has serious symptoms or a high fever, call your healthcare professional. You may need treatment.

What you can do

Before talking with your healthcare professional, write a list of answers to the following questions:

  • What are the symptoms?
  • When did the symptoms start?
  • Have you or your child been exposed to a person who has or had shigella infection?
  • Do you or your child have a fever? If so, how high is it?

What to expect from your doctor

During the physical exam, your healthcare professional may press on parts of your stomach area. This is done to check for pain or tenderness. Your healthcare professional also may use a cotton swab to get a stool sample. Or you may be given instructions on how to collect and send a sample of your stool to a lab for testing.

Sept. 17, 2024
  1. Agha R, et al. Shigella infection: Epidemiology, clinical manifestations, and diagnosis. https://www.uptodate.com/contents/search. Accessed March 7, 2024.
  2. Agha R, et al. Shigella infection: Treatment and prevention in adults. https://www.uptodate.com/contents/search. Accessed March 7, 2024.
  3. Kliegman RM, et al. Shigella. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed March 7, 2024.
  4. Shigella — Shigellosis. Centers for Disease Control and Prevention. https://www.cdc.gov/shigella/index.html. Accessed March 7, 2024.
  5. Walls RM, et al., eds. Pediatric infectious diarrheal disease and dehydration. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed March 7, 2024.
  6. Kimberlin DW, et al. Shigella infections. In: Red Book Online. 32nd ed. American Academy of Pediatrics; 2021. https://publications.aap.org/redbook. Accessed March 7, 2024.
  7. Bismuth subsalicylate. Merative Micromedex. https://www.micromedexsolutions.com. Accessed March 8, 2024.
  8. LaRocque R, et al. Approach to the adult with acute diarrhea in resource-abundant settings. https://www.update.com/contents/search. Accessed March 8, 2024.

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