Indiana University Infectious Diseases Fellowship
14 Mar,
14 tweets, 8 min read
#idboardreview 30 MSM PLWH Cd4 800 VL<20 on ART presents w/ 2wk abd cramps & watery diarrhea. Blood agar: translucent, flat bacterial colony that appeared to spread across plate. Dx? #medEd #idmedEd #IDtwitter 
#Shigellosis acute diarrhea, vomiting & abdominal cramps. (1) Stools often contain blood, although some have watery diarrhea. Rarely, severe shigellosis may be complicated by rectal prolapse, intestinal obstruction & colonic perforation. Post infect Reactive arthritis 1-2 wks
#Shigella sp are highly infectious; as few as 10 organisms sufficient to cause disease.(2) Contact w/infected individuals or contaminated food➡️transmission. As an emerging sexually-transmitted infection in MSM, #shigellosis is associated with direct or indirect oral-anal contact
In patients with normal immune function: #shigella generally self-limited, resolving after 7d on average; however, pt remain infectious for upto 4wk as pathogens continue to be shed in feces. reportable illness &documentation of stool culture clearance required in food-handlers
#shigella healthcare workers, antibiotic therapy is recommended to reduce the duration of disease and decrease the risk of continued transmission.
#shigella #sonnei, along with S. flexneri serotypes 2a and 3a, are the strains most frequently implicated in outbreaks in MSM populations
#Shigella species are often intrinsically resistant to multiple antibiotics including ampicillin, trimethroprim-sulfamethoxazole and quinolones, and reduced susceptibility to azithromycin is now being reported around the worl
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