Shigella spp.

One-Sentence Definition

Shigella species are non-motile, lactose-non-fermenting Enterobacterales that cause bacillary dysentery via intestinal invasion and Shiga toxin (some species) — low infectious dose and person-to-person spread.

Taxonomy & Morphology

  • S. dysenteriae, S. flexneri, S. boydii, S. sonnei
  • Gram-negative bacillus; non-lactose on MacConkey; closely related to Escherichia coli phylogenetically

Virulence Highlights

  • M cell invasion; intercellular spread
  • Shiga toxin (S. dysenteriae type 1) — HUS risk (similar mechanism to STEC)
  • Very low inoculum — outbreaks in crowded settings

Clinical Syndromes

  • Bloody diarrhea, cramps, fever (dysentery)
  • Complications: dehydration, HUS (toxin-mediated), reactive arthritis

Diagnosis

  • Stool culture on selective media; PCR on GI panels
  • Distinguish from STEC — toxin testing and epidemiology

Treatment Notes (conceptual)

  • Supportive hydration central
  • Antibiotics shorten shedding in severe cases — resistance common; follow local guidelines
  • Avoid antimotility agents in invasive diarrhea when possible

AMR Relevance

  • MDR Shigella globally (fluoroquinolone, azithromycin resistance patterns vary)

Active Recall

  1. Why is person-to-person spread efficient?
  2. Shigella vs STEC — shared toxin concern?
  3. Lactose fermentation on MacConkey?