Chapter 191 Shigella
Clinical Manifestations and Complications
S. dysenteriae serotype 1 infection is commonly complicated by hemolysis, anemia, and HUS. This syndrome is caused by Shiga toxin–mediated vascular endothelial injury. E. coli that produce Shiga toxins (e.g., E. coli O157:H7, E. coli O111:NM, E. coli O26:H11) also cause HUS (Chapter 512).
Treatment
As with gastroenteritis from other causes, the first concern in a child with suspected shigellosis should be for fluid and electrolyte correction and maintenance (Chapter 332). Drugs that retard intestinal motility (e.g., diphenoxylate hydrochloride with atropine [Lomotil] or loperamide [Imodium]) should not be used because of the risk of prolonging the illness.
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