Shigellosis: infectious disease

Apr 8th, 2015
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Study guide on Shigellosis

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SHIGELLOSISBACILLARY DYSENTERY(SHIGELLOSIS)This is an acute infectious inflammatory colitis.Gram-negative rodsfour main groups: Sh. dysenteriae, flexneri, boydii andsonnei.Sh. Dysenteriae- most severe diseaseCulture- non-lactose fermenters (MacConkey &EMB), non-motile, non-H2S producers(TSI slant agar)EpidemiologyFecal- oral spread (5Fs) Although shigellae are found world-wide,transmission is strongly associated withpoor hygiene. More prevalent in the developing world,where the main burden falls onchildren( under 5) Only small numbers need to be ingestedto cause illness < 200 (i.e. very acidstable)Pathogenesis1.2.Invasive: Invade M cells, get into thecytoplasm,replicate & then polymerize actin jettrails & go laterally into adjacent cells withoutthe need to go back into the ECF. Thus RBCs& PMNs in stoolEndotoxin: (Shiga toxin). Produced by Sh.Dysenteriae type 1. Has 3 acivities :Neurotoxic, cytotoxic & enterotoxic. A-Btoxin. Inhibits protein synthesis by clippingthe 60S ribosomal subunit. Recall which othertoxin has a similar mode of action?Clinical features1-4 day incubation preiodDisease severity varies:1.Sh. sonnei infections- mild & may escape detection2.Sh. flexneri infections- more severe3.Sh. Dysenteriae-most severe form of dysentery may befulminating and cause death within 48 hoursDiarrhoea-mucus,bloody with PMNsColicky abdominal painTenesmusFever(

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