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Shigella infection: Treatment and prevention in children

Shai Ashkenazi, MD, MSc
Section Editor
Sheldon L Kaplan, MD
Deputy Editor
Mary M Torchia, MD


Shigella infections are a major cause of pediatric morbidity and mortality worldwide. (See "Shigella infection: Epidemiology, microbiology, and pathogenesis".)

Shigella infection is characterized by high fever (>38.5°C [101.3°F]), abdominal cramps, diarrhea, tenesmus, and polymorphonuclear leukocytes on a methylene blue stain of the stool; extraintestinal manifestations and complications also occur (table 1) [1]. Definitive diagnosis requires a stool culture. The characteristic small-volume, bloody/mucous stools are present in approximately one-half of the children with shigellosis [1]. Neonates [2] and children with underlying immune deficiency (including HIV infection) [3,4] or malnutrition [5,6] are at increased risk of bacteremia and other complications of shigellosis. (See "Shigella infection: Clinical manifestations and diagnosis".)

The treatment of and prevention of Shigella infection in children will be reviewed here. The microbiology, epidemiology, pathogenesis, clinical manifestations, and diagnosis of Shigella infection in children are discussed separately, as is the treatment of Shigella in adults. (See "Shigella infection: Epidemiology, microbiology, and pathogenesis" and "Shigella infection: Clinical manifestations and diagnosis" and "Shigella infection: Treatment and prevention in adults".)


Infection with Shigella generally is self-limited; the average duration of gastrointestinal symptoms in untreated Shigella gastroenteritis is about seven days [7]. In the absence of specific antibiotic treatment, children with Shigella gastroenteritis shed the organism for up to four weeks; children with immune deficiency shed for much longer periods, even if their symptoms have resolved [1,3,4].


Correction of fluid and electrolyte losses is the mainstay of treatment of acute gastroenteritis in children, no matter the cause [1]. Oral rehydration is preferred when feasible [8], but intravenous fluids may be necessary. Fluid repletion in children is discussed separately. (See "Oral rehydration therapy" and "Treatment of hypovolemia (dehydration) in children".)


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Literature review current through: Sep 2016. | This topic last updated: Sep 7, 2016.
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