Shigellosis in Children

Shigellosis is an infection of the intestines. It can cause diarrhea, pain in the abdomen, and other symptoms. The infection usually lasts 5–7 days.

Most children with this infection make a full recovery. In rare cases, some children can develop lasting problems, such as arthritis, irritation of the eyes, skin rashes, or a kidney problem called hemolytic uremic syndrome.

What are the causes?

This infection is caused by Shigella bacteria. This bacteria can spread through a person’s stool. A child may get this infection by:

• Eating or drinking something that has the bacteria on it.
• Touching something that has the bacteria on it and putting that hand in his or her mouth.
• Swimming in water that has the bacteria in it.

What are the signs or symptoms?

Symptoms of this infection may start 1–3 days after the bacteria gets into the body. Symptoms include:

• Diarrhea, commonly with blood or mucus.
• Pain or cramps in the abdomen.
• Fever.
• Nausea.
• Vomiting.
• Loss of appetite.
• Feeling the need to have another bowel movement even after just having one (tenesmus).

How is this diagnosed?

This condition may be diagnosed based on:

• Your child’s symptoms.
• Your child’s medical history.
• A physical exam.
• A stool test.

How is this treated?

To manage this condition, your child may need to:

• Drink plenty of fluids. This is important because the infection can make your child dehydrated.
• Take antibiotic medicines. These may be used if the infection is severe. They may help shorten your child’s illness and keep others from getting sick.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not give your child medicines to treat diarrhea. These medicines can make the infection worse.
• If your child was prescribed an antibiotic medicine, give it as told by your child’s health care provider. Do not stop giving the antibiotic even if your child starts to feel better.

Eating and drinking

• Make sure your child drinks enough fluid to keep his or her urine pale yellow.
• Encourage your child to drink clear fluids, such as water, low-calorie popsicles, and diluted fruit juice until the diarrhea, nausea, or vomiting is under control.
• Continue to breastfeed or bottle-feed your young child. Do this in small amounts and frequently. Gradually increase the amount. Do not give extra water to your infant.
• Keep track of how much your child drinks and urinates. If your child urinates less than normal or less often than normal, your child may be dehydrated.
• Give your child an oral rehydration solution (ORS) as told by your health care provider. This drink is sold at pharmacies and retail stores.
• If your child is not hungry, do not force your child to eat.
• Give your child bland, easy-to-digest foods in small amounts every 3–4 hours, if your child is eating solid food. These foods include bananas, applesauce, rice, lean meats, toast, and crackers.
• Avoid giving your child:
  • Foods and drinks that are high in sugar.
  • Carbonated soft drinks.
  • Fruit juice.
  • Gelatin desserts.
  • Foods that are high in fat.
  • Spicy foods.

General instructions

• Wash your hands often, and have your child wash his or her hands often. This helps keep the bacteria from spreading to others. Use soap and water, or use hand sanitizer if soap and water are not available.
• Keep track of changes in your child’s weight. Losing a lot of weight can be a sign of a serious problem. Ask your child’s health care provider how much weight loss should concern you.
• Dispose of diapers properly.
• Clean changing tables with antibacterial cleaners.
• Keep your child home from work, school, or daycare as told by your child’s health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if your child:

• Has a fever.
• Has diarrhea that has more blood or mucus than before.
• Has weight loss.
• Feels very thirsty.
• Has little energy.
• Has dry lips or a very dry mouth.
• Has sunken soft spots on the head (fontanelles) in younger children.
• Has decreased urine production. This may result in fewer wet diapers produced by infants and toddlers.
• Has redness, irritation, or pain in his or her eyes.
• Has a skin rash.
• Has pain when urinating.
• Has swelling or a feeling of warmth in a joint.

Get help right away if your child:

• Cannot keep fluids down.
• Cannot stop vomiting or having diarrhea.
• Has pain in the abdomen, and the pain gets worse.
• Is younger than 3 months and has a temperature of 100.4°F (38°C) or higher.
• Has signs of severe dehydration, such as:
  • Extreme thirst.
  • Cold hands and feet.
  • Rapid breathing.
  • Confusion.
  • Difficulty being woken up.
  • No tears.
  • Dizziness.

Summary

• Shigellosis is an infection of the intestines that can cause diarrhea and pain in the abdomen. The diarrhea is often bloody. The infection usually lasts 5–7 days.
• This infection is caused by Shigella bacteria. These bacteria can spread through a person’s stool.
• Children with this infection need to drink plenty of fluids to prevent dehydration. Children with a more severe infection may need to take antibiotic medicines.
• Most children with this infection make a full recovery. In rare cases, some children can develop lasting problems, such as arthritis, skin rashes, and kidney problems.