Shigella (S. boydii, S. sonnei, S. flexneri & S. dysenteriae)

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Shigella spp. are non-sporulating bacteria that belong to the family Enterobacteriaceae. Shigella infections account for 5% to 20% of all diarrheal episodes throughout the world, and although these infections are commonly seen in children younger than five years old, they can be found in adults of all ages. Shigellosis often begins with fever, watery diarrhea, and abdominal cramps, and can progress to bloody diarrhea.

Shigellosis is usually self- limiting, but can become life-threatening if patients are immuno-compromised. Contaminated food or water (recreation or drinking) is a source of exposure and fecal-oral transmission at daycare or nursing homes facilities is common. Incubation period is typically 3-4 days. Antimotility agents are contraindicated and antibiotics may decrease the course of illness by two days which may be considered in immunocompromised or to prevent shedding (public health precaution). Recommendations include Trimethoprim/ sulfamethoxazole 160-800 mg twice daily for 3 days, Levofloxacin 500 mg daily for 3 days, Ciprofloxacin 500 mg twice daily for 3 days and clear liquid, lactose (dairy)-free diet may be used until symptoms resolve. Essential oils of Pinus sylvestris (pine), Thymus officinalis (thyme), Melaleuca alternifolia (tea tree), Coriandrum sativum (coriander seed), Cymbopogon citrates (lemon grass), Mentha piperita (peppermint), and Melissa officinalis (lemon balm) have been shown to have antimicrobial effects against E. coli spp. in vitro. Aqueous, ethanol and methanol extracts of Triphala churna; ethanol extract of Mahsudarshan churna; methanol extract of Sukshsarak churna have all been shown to have antimicrobial activity against E. coli in vitro.

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