Intestinal manifestations of invasive diarrheas and their diagnosis.

Data from studies of 916 children with diarrhea, including 122 from whom shigellae were isolated, and data on patients affected in an epidemic due to Shigella dysenteriae type I were analyzed to determine whether a diagnostic clinical profile of shigellosis could be identified. Blood and/or mucus in stool, increased frequency of stool, abdominal pain, rectal tenesmus, and fever were noted more frequently in patients with shigellosis. The diagnostic confirmation of shigellosis depends on the isolation of the organism, but in the clinical situation early initiation of appropriate antibiotic therapy can be based on clinical judgment that utilizes local perceptions regarding dysentery.