Shigella infection is a bacterial infection that occurs in the digestive tract. This infection occurs when bacteria enter the body through contact with feces or through contaminated food or drink.
Shigella infection or shigellosis is caused by a group of bacteria Shigella, like bacteria Shigella dysenteria, Shigella sonnei, and Shigella flexneri. This bacterium is classified as very infectious. That is, in small quantities, these bacteria can already cause symptoms in humans.
After entering the mouth, bacteria Shigella will multiply in the small intestine, then spread to the large intestine. Bacteria Shigella can release toxins that cause intestinal cell damage and inflammation. This condition causes severe cramping and diarrhea symptoms, which can even occur 10–30 times a day.
Causes of Shigella Infection
Shigella infection is caused by bacteria Shigella inadvertently entered the mouth. This can occur due to the following conditions:
- Touching your mouth without washing your hands first after touching a surface infected with bacteria Shigella, for example the diaper of a child who has shigellosis or an object that has been touched by a person with Shigella infection
- Eating food contaminated with bacteria Shigella, for example because food is prepared unhygienicly by people with shigellosis or because food is made from materials contaminated with human waste
- Swallowing water that has been contaminated with bacteria Shigella, for example from swimming in water that has been contaminated by a Shigella infection
- Having oral sex that causes the mouth to touch the anus or the area around the anus
Shigella Infection Risk Factors
There are several conditions that can increase a person's risk of getting Shigella infection, namely:
- 2–4 years old
- Living in an environment with poor sanitation or traveling to an area with poor sanitation
- Living in groups, for example in nursing homes, dormitories, prisons, or military barracks
- Activities in public places, such as daycare or public swimming pools
- Having sex with other men (for men)
- Have a weak immune system, for example due to suffering from HIV/AIDS
Symptoms of Shigella Infection
Symptoms of Shigella infection generally appear 2-3 days after the patient is exposed to the bacteria Shigella. In some cases, symptoms can appear a week after contact with the bacteria Shigella.
Symptoms of Shigella infection usually last for 2–7 days. Symptoms commonly experienced by patients with Shigella infection are dysentery symptoms, namely:
- Abdominal pain or cramping, especially in the middle of the abdomen
- Constant heartburn, accompanied by a feeling of not being able to hold a bowel movement
- Water predominant diarrhea
- There may be blood or mucus in the stool
- High fever (can be more than 40o C)
- Nauseous
- Throw up
When to go to the doctor
Check with a doctor if you have diarrhea for more than 3 days, so that dehydration does not occur. Do not delay seeing a doctor if diarrhea is severe more than 10 times per day, has blood in the stool, or is accompanied by a fever.
Diagnosis of Shigella Infection
To diagnose, the doctor will ask the patient's symptoms and complaints. In addition, the doctor can also ask questions related to risk factors that the patient may have, such as the patient's food history in the past 1 week or the patient's place of residence.
Diarrhea or bloody stools can be caused by many things. To determine whether diarrhea or bloody stools are caused by Shigella infection, the doctor will perform a stool examination. In addition to determining the cause, stool examination can also help doctors determine the most effective type of antibiotic for the patient.
Shigella Infection Treatment
Mild Shigella infections go away on their own in 5–7 days. However, during diarrhea, patients are advised to drink lots of water to replace lost body fluids and prevent dehydration. Doctors may also give zinc supplements to speed healing.
It is important to remember, while diarrhea occurs, the patient should not take diarrhea-stopping drugs. This will actually make the bacteria stay in the digestive system longer and worsen the infection.
Antibiotics to treat diarrhea are usually used in severe Shigella infections or in patients with weakened immune systems, such as the elderly and infants. Types of antibiotics that can be prescribed include:
- Azithromycin
- Ciprofloxacin
- Sulfamethoxazole
Shigella infection rarely requires hospitalization, unless the patient has severe nausea and vomiting and is unable to eat or drink. In this condition, the doctor will give medicine and replacement of body fluids through an IV.
Shigella Infection Complications
Shigella infections generally resolve without causing complications. However, in some cases, patients may experience the following complications:
- Dehydration, which occurs as a result of persistent diarrhea
- Reactive arthritis, which occurs as a reaction to infection, is characterized by pain in the knee, hip, and ankle joints
- Rectal prolapse, which is the passage of part of the rectum (lower part of the large intestine) due to straining or severe inflammation of the large intestine
- Seizures, which can be caused by a fever or by bacteria Shigella itself
- Hemolytic uremic syndrome
- Toxic megacolon, which can occur when the intestines are paralyzed, making it unable to defecate and pass urine
- Intestinal perforation or intestinal wall damage
- Blood infection (bacteremia), which can occur when bacteria Shigella enter the bloodstream through the damaged intestinal lining
Shigella Infection Prevention
Some things that can be done to prevent Shigella infection are:
- Wash hands with soap and water regularly, especially before and after using the toilet, after changing diapers, and before eating
- Supervise children while they wash their hands
- Keep children with diarrhea away from other children
- Dispose of used diapers in a tightly closed bag
- Do not serve food if you have diarrhea
- Avoid swallowing water when swimming in public pools or lakes
- Avoid having sex with people who have diarrhea or have recently recovered from diarrhea
- Not having oral sex or anal sex