Treatment:

The symptoms usually last 2 to 7 days. The goal of treatment is to replace fluids and electrolytes (salt and minerals) lost in diarrhea.

Medications that stop diarrhea are generally not given because they may prolong the course of the disease.

Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. Several varieties of electrolyte solutions are now available over the counter.

Antibiotics can help shorten the length of the illness and help prevent it from spreading to others in group living or day care situations. They may also may be prescribed for patients with severe symptoms. Frequently used antibiotics include sulfamethoxazole and trimethoprim (Bactrim), ampicillin, ciprofloxacin (Cipro), or azithromycin.

Persons with diarrhea who cannot drink fluids by mouth because of nausea may need medical attention and fluids through a vein ( intravenously).This is especially common in small children.

Persons who take diuretics ("water pills") may need to stop taking such medicines if they have acute shigella enteritis. Never stop taking any medicine without first talking to your health care provider.

Expectations (prognosis):

Often the infection is mild and goes away on its own. Most patients, except malnourished children and those with weakened immune systems, have an excellent outlook.

Complications:

• Dehydration - severe
• Hemolytic-uremic syndrome (HUS), a form of kidney failure with anemia and clotting problems
• Reactive arthritis

Up to 40% of children with severe shigella enteritis develop neurological problems including febrile seizures or brain disease (encephalopathy) with headache, lethargy, confusion, and stiff neck.

Calling your health care provider:

Call your provider if diarrhea does not improve, if there is blood in the stool, or if there are signs of dehydration.

Go to the emergency room if the following occur in a person with shigellosis:

• Confusion
• Headache with stiff neck
• Lethargy
• Seizures

Such symptoms are most common in children.