Shigellosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Yazan Daaboul; Serge Korjian

Overview

Shigellosis must be differentiated from other diseases that cause fever, bloody diarrhea, dehydration, tachycardia and low blood pressure, such as Enterohemorrhagic E.coli (EHEC) infection, Ebola, Typhoid fever, Malaria, and Lassa fever.

Differentiating Shigellosis from other Diseases

The table below lists the underlying bacterial pathogens known to cause acute diarrhea:[1][2]

Pathogen Transmission Clinical Manifestations
Fever Nausea/Vomiting Abdominal Pain Bloody Stool
Salmonella Foodborne transmission, community-acquired ++ + ++ +
Shigella Community-acquired, person-to-person ++ ++ ++ +
Campylobacter Community-acquired, ingestion of undercooked poultry ++ + ++ +
Escherichia coli Foodborne transmission, ingestion of undercooked hamburger meat - + ++ + (EHEC or EIEC), - (ETEC, EAEC, EPEC)
Clostridium difficile Nosocomial spread, antibiotic use + ± + +
Yersinia Community-acquired, foodborne transmission ++ + ++ +
Entamoeba histolytica Travel to or emigration from tropical regions + ± + ±
Aeromonas Ingestion of contaminated water ++ + ++ +
Plesiomonas Ingestion of contaminated water or undercooked shellfish, travel to tropical regions ± ++ + +

References

  1. Thielman NM, Guerrant RL (2004). "Clinical practice. Acute infectious diarrhea". N Engl J Med. 350 (1): 38–47. doi:10.1056/NEJMcp031534. PMID 14702426.
  2. Khan AM, Faruque AS, Hossain MS, Sattar S, Fuchs GJ, Salam MA (2004). "Plesiomonas shigelloides-associated diarrhoea in Bangladeshi children: a hospital-based surveillance study". J Trop Pediatr. 50 (6): 354–6. doi:10.1093/tropej/50.6.354. PMID 15537721.


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