Shigella infection

Diagnosis

Diarrhea and bloody diarrhea can result from a number of diseases. Confirming shigella infection involves taking a sample of your stool to be tested in a lab for the presence of shigella bacteria or their toxins.

Treatment

Shigella infection usually runs its course in five to seven days. Replacing lost fluids from diarrhea may be all the treatment you need, particularly if your general health is good and your shigella infection is mild.

Over-the-counter drugs

Talk to your doctor before taking an over-the-counter (OTC) drug intended to treat diarrhea. Diarrhea can be caused by a number of conditions, and OTC drugs may make some conditions worse.

If a lab test has confirmed that you have shigella infection, an OTC drug containing bismuth subsalicylate (Pepto-Bismol, Kaopectate) may help decrease the frequency of your stools and shorten the length of your illness. However, it isn't recommended for children, pregnant women or people who are allergic to aspirin.

Avoid taking OTC anti-motility drugs, such as loperamide (Imodium) and drugs containing the combination of diphenoxylate and atropine (Lomotil). These aren't recommended for shigella infection because they can decrease your body's ability to clear the bacteria and make your condition worse.

Antibiotics

For severe shigella infection, antibiotics may shorten the length of the illness. However, some shigella bacteria have become drug resistant. So your doctor may not recommend antibiotics unless your shigella infection is severe.

Antibiotics may also be necessary for infants, older adults and people who have HIV infection, as well as in situations where there's a high risk of spreading the disease.

Fluid and salt replacement

For generally healthy adults, drinking water may be enough to counteract the dehydrating effects of diarrhea.

Children may benefit from an oral rehydration solution, such as Pedialyte, available in drugstores. Many pharmacies carry their own brands.

Children and adults who are severely dehydrated need treatment in a hospital emergency room, where they can receive salts and fluids through a vein (intravenously), rather than by mouth. Intravenous hydration provides the body with water and essential nutrients much more quickly than oral solutions do.

Preparing for your appointment

Most people who have shigella infection get better on their own and don't need to see a doctor. If you or your child has severe symptoms or a high fever, you may need treatment.

What you can do

Before talking with your doctor, you may want to 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 doctor may press on various parts of your abdomen to check for pain or tenderness. He or she may also use a cotton swab to get a stool culture or send you home with instructions for collecting and transporting a sample of your stool so that it can be tested for evidence of infection.