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3. Gastrointestinal disorders
– N ever give lo pera m id e o r a n y o ther a n tid ia rrho ea l.
– C o m plica tio n s o f s higello s is d ue to S d 1 :
• s eptica em ia : s ee antibiotic treatment of septic shock (pa ge 2 0 )
• a cute a b d o m en : s ee antibiotic treatment of septic shock (pa ge 2 0 ) a n d la pa ro to m y
• s eizures : diazepam (pa ge 2 3 ) a n d fluid res trictio n
• m o d era te to s evere ha em o lytic ura em ic s yn d ro m e, m a y req uire tra n s fus io n
an d/ o r
ha em o d ia lys is .
Shigellosis in an epidemic context (Sd1) 3
– A n tib io tic res is ta n ce d evelo ps ra pid ly (s o m etim es d urin g the co urs e o f a n
epid em ic).
A fter co n firm in g the ca us a l a gen t, a n tim icro b ia l s us ceptib ility s ho uld b e
m o n ito red
m o n thly b y culture a n d s en s itivity tes ts .
– Pa tien ts pres en tin g w ith s ign s o f s erio us illn es s o r w ith ris k fa cto rs a re
ho s pita lis ed
fo r the d ura tio n o f trea tm en t a n d a re m o n ito red d a ily (clin ica lly a n d fo r
co m plia n ce).
– Pa tien ts w ith n either s ign s o f s erio us illn es s n o r ris k fa cto rs a re trea ted a s
o utpa tien ts .
O rga n is e ho m e vis its fo r d a ily m o n ito rin g (clin ica lly a n d fo r co m plia n ce);
ho s pita lis e
if the pa tien t d evelo ps s ign s o f s erio us illn es s .
– H ygien e m ea s ures : is o la te pa tien ts a s fo r cho lera , in d ivid ua l a n d co llective
hygien e.
S h igello s is is a n ext rem ely co n t a gio us d is ea s e ( t h e in ges t io n o f 1 0
b a ct eria is
in fective).
Note: o ver th e pa s t few yea rs , S d 1 epid em ics o f s m a ller s ca le a n d w ith lo w er
ca s e
fa ta lity ra tes (les s tha n 1 % ) ha ve b een o b s erved .
– N ever give lo pera m id e o r a n y o ther a n tid ia rrho ea l.
– C o m plica tio n s o f s higello s is d ue to S d 1 :
• s eptica em ia : s ee antibiotic treatment of septic shock (pa ge 2 0 )
• a cute a b d o m en : s ee antibiotic treatment of septic shock (pa ge 2 0 ) a n d la pa ro to m y
• s eizures : diazepam (pa ge 2 3 ) a n d fluid res trictio n
• m o d era te to s evere ha em o lytic ura em ic s yn d ro m e, m a y req uire tra n s fus io n
an d/ o r
ha em o d ia lys is .
Shigellosis in an epidemic context (Sd1) 3
– A n tib io tic res is ta n ce d evelo ps ra pid ly (s o m etim es d urin g the co urs e o f a n
epid em ic).
A fter co n firm in g the ca us a l a gen t, a n tim icro b ia l s us ceptib ility s ho uld b e
m o n ito red
m o n thly b y culture a n d s en s itivity tes ts .
– Pa tien ts pres en tin g w ith s ign s o f s erio us illn es s o r w ith ris k fa cto rs a re
ho s pita lis ed
fo r the d ura tio n o f trea tm en t a n d a re m o n ito red d a ily (clin ica lly a n d fo r
co m plia n ce).
– Pa tien ts w ith n either s ign s o f s erio us illn es s n o r ris k fa cto rs a re trea ted a s
o utpa tien ts .
O rga n is e ho m e vis its fo r d a ily m o n ito rin g (clin ica lly a n d fo r co m plia n ce);
ho s pita lis e
if the pa tien t d evelo ps s ign s o f s erio us illn es s .
– H ygien e m ea s ures : is o la te pa tien ts a s fo r cho lera , in d ivid ua l a n d co llective
hygien e.
S h igello s is is a n ext rem ely co n t a gio us d is ea s e ( t h e in ges t io n o f 1 0
b a ct eria is
in fective).
Note: o ver th e pa s t few yea rs , S d 1 epid em ics o f s m a ller s ca le a n d w ith lo w er
ca s e
fa ta lity ra tes (les s tha n 1 % ) ha ve b een o b s erved .
