Shigella infections.

Shigellosis is a complex disease involving two distinct organs and two distinctive clinical presentations of intestinal involvement. It is also associated with a wide variety of extra-intestinal manifestations. Because these may precede the onset of diarrhoea/dysentery, and confuse the diagnosis, it is safe to denote shigellosis as a protean clinical problem. The disease is readily spread by contact because so few organisms are required to establish infection. It may also be spread through contaminated food or water, related to either defective sewage or a human carrier, and explosive outbreaks may occur in closed populations. Homosexuals are also at risk of venereal transmiddion of infection. Shigellosis is treatable with effective oral antimicrobials, responding both clinically and microbiologically. When organism are sensitive, ampicillin is the current drug of choice, and when they are resistant to ampicillin, trimethoprim-sulphamethoxazole appears to be the best choice. Dehydration is not usually severe, and responds to oral rehydration therapy, which is highly recommended along with early refeeding.