1. The document presents information on shigellosis from Group 5 project members including Alex Mbewe. 2. Shigellosis is an acute bacterial infection of the intestines caused by Shigella bacteria which can be spread through contaminated food, water, or direct contact. 3. Symptoms include abdominal pain, fever, bloody diarrhea, and dehydration. Treatment focuses on rehydration and antibiotics in severe cases.

1. GROUP 5 MEMBERS
1. Alex Mbewe
2. Monica Banda
3. Rosella Munyenyembe
4. Andrew Moyo
5. Nelson Munthali
6. Mtisunge Wandale
7. Jacqualine Ntaba

2. PRESENTS
SHIGELLOSIS
By ALEX ‘ SIAL’ MBEWE

3. BROAD OBJECTIVE
By the end of this presentation, learners
should acquire knowledge on how to
manage a patient with shigellosis.

4. SPECIFIC OBJECTIVES
O Definition of shigellosis
O Causes of shigellosis
O Types
O How it is spread
O Pathophysiology
O Clinical manifestations
O Medical management
O Nursing management
O Complications

5. Definition
O This is an acute bacterial infection
of the lining of the intestines
(especially large intestines)
Causes
Shigellosis is caused by a group of
bacteria called shigella (gram-
negative organism)

6. Types
1. Shigella sonei – also called group D. it is
responsible for most of the cases
2. Shigella flexineri
 Also called group B
3. Shigella dysenteriae
 Can lead to outbreaks in developing
countries

7. SPREAD
O Shigellosis is spread through fecal-oral
route
O People with shigellosis release it through
the stools
O It spreads from one infected person to
contaminate water or food or directly to
another person.
O Outbreaks are associated with poor
sanitation, contaminated food or water
and crowded living conditions
O Common among travelers in developing
countries and workers or residents of
refuge camps

8. CLINICAL MANIFESTATIONS
O Usually develop about 1-7 days (average 3
days) after you come into contact with the
bacteria
O Acute (sudden) abdominal pain or
cramping
O Acute (sudden) fever
O Blood, mucus or pus in stools
O Crampy rectal pain
O Nausea and vomiting

9. O Watery diarrhoea
O Abdominal tenderness
O Dehydration with fast heart rate and
low Bp
O Loss of appetite

10. Diagnostic tests
O Stool culture
O White blood cells in stools
O Elevated blood cell count (FBC)

11. PATHOPHYSIOLOGY
O Once ingested, the bacteria survives the gastric
environment of the stomach and progresses to
large intestines
O There, they attach to and penetrate the
epithelial cells of the intestinal mucosa.
O After invasion, they multiply intracellulary and
spread to neighboring epithelial cells, resulting
in tissue destruction.
O It produces toxins that can attack the lining of
the large intestines, causing swelling, ulcers on
the intestinal wall and bloody diarrhoea.

12. Pathophysiology cont….
O Severity of diarrhoea sets apart
shigellosis from regular diarrhoea
and it is usually associated with
bloody or pus stained diarrhoea.

13. MEDICAL MANAGEMENT
O The goal is to replace fluids and electrolytes
O Advise patient on diet
O Self measure to avoid dehydration like drinking
electrolyte solution to replace fluids e.g. ORS
O Antibiotics only in severe cases e.g. ampicillin
and ciprofloxacin 250mg BD IV-they shorten
the length of illness
O Antidiarrhoea agents e.g. Loperamide 2mg BD
O I.V fluids 2-3 litres/24hrs e.g. R/L
O Stop taking diuretics

14. NURSING MGT
O ASSESSMENT
- History of stool pattern and
associated symptoms
O Frequency
O Duration
O Character
O Consistency of stools
O history of medication
 use of other drugs known to
cause diarrhoea e.g. laxatives
O Social history

15. NURSING MGT CONT……
O Family history
O Recent travel, stress, health and
family history of illness
O Eating habits, appetite, food
intolerance especially milk and
other dairy products

16. Objective data
 Lethargy
 Sunken eye balls
 Fever
 Pallor
 Dry mucous membranes
 Poor skin turgor
 Parienal irritational
 Malnutrition
 Concentrated urine

17. Physical examination
O Vital signs and weight measurement
O Patients’ skin is inspected for signs of
dehydration
O Poor turgor and dryness and area of
breakdown of the skin
O Abdomen
• Distension
• Bowel sounds
• Palpate for tenderness

18. Nursing diagnosis
O Diarrhoea r/t acute infectious process
evidenced by frequent loose and liquid
stools
O Fluid and electrolyte imbalance r/t
diarrhoea and vomiting
O Nutritional imbalance; less than body
requirements r/t loss of
appetite, nausea, vomiting evidenced by
weight loss
O Altered thermoregulation hyperthermia r/t
to the infection as evidenced by rise of
temperature to 38 degrees celsius

19. O Altered comfort (abdominal pain) r/t
increased peristalsis evidenced by
patient’s verbalization and facial
expression
O Risk for anemia related to blood in
stools
O Risk for altered skin integrity related to
dehydration
O Risk for Hypovolemic shock r/t loss of
fluids due to diarrhoea

20. Interventions
O Commence IV fluids as ordered e.g. R/L – to
replace lost fluids and correct electrolyte balance
O Catheterize – to monitor input and output and
balance fluids
O Enforce strict IP measures to avoid cross
infection
O Provide small and frequent food to normalize
nutritional status and reduce peristalsis
movement
O Administer prescribed antipyretics e.g. panadol
1g tds po. This will act on the prostagrandin of
the hypotharamus hence it will reduce fever.

21. O Administer analgesics e.g. panadol 1g po
tds to reduce pain .

22. complications
O Intestinal perforation
O Dehydration
O Hypoglycemia
O Coma
O Rectal prolapse
O Hypovolemic shock
O Bacteremia
O Peritonitis

23. References
O Lewis S.M., Heitkemper M.M and Dirksen S.R.
(2010). Medical surgical nursing assessment
and management of clinical problems.(7thed) St
Louis:C.V.Mosby
O Smeltzer S.C., Bare B.G and Hinke J.L (2010).
Brunner & suddarth’s textbook of medical
surgical nursing.(12th ed). Philadelphia:J.B
Lippincott
O www.mayoclinic.com