What is the pathophysiology of shigellosis?

Updated: Aug 20, 2021
  • Author: Heba Rashid Ashraf, MD; Chief Editor: BS Anand, MD  more...
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Answer

Shigella organisms cause bacillary dysentery, [8, 9, 10] a disease that has been described since early recorded history.

Shigella species (eg, S dysenteriae, S flexneri, S sonnei, S boydii) are aerobic, nonmotile, glucose-fermenting, gram-negative rods that are highly contagious, [9, 11] causing diarrhea after ingestion of as few as 180 organisms. [12]

These pathogens cause damage by two mechanisms, (1) invasion of the colonic epithelium, which is dependent on a plasmid-mediated virulence factor, [8, 9, 10] and (2) production of an enterotoxin, which is not essential for colitis but enhances the virulence.

Lapaquette et al indicate that S flexneri uses a calcium/calpain-dependent mechanism to cause sumoylation inhibition, thereby allowing pathogenic bacterial entry. [13]  

The organism is spread by fecal-oral contact via infected food or water, during travel or in long-term care facilities, daycare centers, or nursing homes. [14]


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