A 3 year old boy in day-care comes into the hospital bloody diarrhea, fever, abdominal pain, and vomiting. The enteric symptoms were of rapid-onset.
Labs: Stool examination reveals PMNs and aerobic gram negative rods that do not ferment lactose. Non-motile and do not produce H2S.
Discussion: Diagnosis of dysentery caused by Shigella is confirmed by labs. Unlike Salmonella, Shigella is non-motile and does not produce H2S. Also, the dose required for infection by Salmonella enteritidis is much greater than the dose required for infection by Shigella. Shigella dysenteriae presents with bloody diarrhea, cramps, fever and leukocytes. The organism invades the mucosa but not beyond. It creates a clinical picture of cramping, abdominal pain, and diarrhea. It is transmitted by the oral-fecal route and is common in the day-care setting. Adults may also be infected.
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