Shigellosis (bacillary dysentery)

Shigellosis is an acute self-limiting intestinal infection which occurs world-wide but is more common in tropical countries and in areas of poor hygiene. Transmission is by the faecal-oral route. The four Shigella species (S.dysenteriae, S.flexneri, S.boydii, and S.sonnei) invade and damage the intestinal mucosa. SOme strains of S.dysenteriae secrete a cytotoxin which results in diarrhoea. Differential diagnosis is from other causes of bloody diarrhoea. Sigmoidoscopic appearances may be the same as those in inflammatory bowel disease. Ciprofloxacin 500mg orally twice daily is the treatment of choice.