Case history
Case history
A 12-year-old boy presents with a 1-week history of sudden-onset watery diarrhoea while visiting relatives in Dhaka, Bangladesh. On his return to the UK, he developed abdominal cramps, fever, and bloody diarrhoea. He is febrile, with a temperature of 38.5°C (101.2°F). The mucous membranes are dry, and there is reduced skin turgor; his pulse is 100 beats/minute, and BP is 110/70 mmHg with a 10 mmHg postural drop.
Other presentations
Shigellosis usually presents as a mild, self-limiting diarrhoeal illness, but Shigella dysenteriae and S flexneri can often cause a more severe illness, with fever and worsening bloody diarrhoea with mucus. Presentations in older, malnourished, or immunosuppressed patients may also be more severe.
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