Symptoms depend largely on the virulence of the infecting E. coli strain. They range from vomiting and a few loose bowel movements, to profuse watery diarrhea, to severe cramps and bloody

Table 24.6 Shigellosis


Fever, dysentery, vomiting, headache, stiff neck, convulsions, and painful joints

Incubation period

3 to 4 days

Causative agent

Species of Shigella, Gram-negative, non-motile enterobacteria


Invasion of and multiplication within intestinal epithelial cells; death of cells, intense inflammation and ulcerations of intestinal lining


Transmission via fecal-oral route; sometimes by fecally contaminated food or water; humans generally the only source

Prevention and treatment

Sanitary measures; surveillance of food handlers and water supplies.Treatment: Antibacterial medications such as ampicillin and cotrimoxazole (trimethoprim plus sulfamethoxazole) shorten duration of symptoms and time shigellas are excreted; multiple R factor resistances may be present

diarrhea. Fever is not usually prominent and recovery usually occurs within 10 days. Hemolytic uremic syndrome, however, develops after some bloody diarrhea cases.

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