Shigellosis natural history, complications and prognosis
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Overview
Infections are associated mucosal ulceration, rectal bleeding, drastic dehydration; fatality may be as high as 10-15% with some strains. Reiter's disease, reactive arthritis, and hemolytic uremic syndrome are possible sequelae that have been reported in the aftermath of shigellosis.
Complications
Reiter's syndrome is a late complication of S. flexneri infection, especially in persons with the genetic marker HLA-B27. Hemolytic-uremic syndrome can occur after S. dysenteriae type 1 infection. Convulsions may occur in children; the mechanism may be related to a rapid rate of temperature elevation or metabolic alterations [1]
- Intestinal Complications (Rare)
- Systemic Complications
- Bacteremia (gram-negative rod's (GNR’s), not just Shigella)
- Hyponatremia (syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Leukemoid Reactions
- Seizure
- Reactive Arthritis
- Hemolytic Uremic Syndrome
Prognosis
Often the infection is mild and goes away on its own. Most patients, except malnourished children and those with weakened immune systems, have an excellent outlook.