SHIGELLOSIS

1. CHIEF COMPLAINT
•Shigellosis

2. HPI
a. Concern:

b. Onset-
•Sudden
•Gradual

c. Duration: ____
•Recent
•A few days
•Many days
•A few weeks
•Many weeks
•A few months
•Many months
•A few years
•Many years
•Recurrent
•N/A.

d. Severity:
•Mild
•Moderate
•Severe
•Absent
•Normal
•Increased
•Decreased
•Stable
•No significant change from prior visit.
•Details

e. Location: lower abdomen

f. Radiation:
 g. Quality :
•Improving
•No change
•Worsening
•Burning pain
•Constricting
•Crushing
•Dull pain
•Heavy
•Sharp pain
•Squeezing
•Stabbing

h. Frequancy

i. Status

j. Context

k. Aggravated by :

l. Relieved by

m. Associated Symptoms

n. Pertinent Negatives

o. Notes

3. ROS

4. SYMPTOMS
• Acute bloody diarrhea
• Crampy abdominal pain
• Tenesmus
• Passage of mucus
• Fever
• vomiting
5. HISTORY

a. FAMILY HISTORY
b. SOCIAL HISTORY
c. PAST MEDICAL HISTORY
d. SURGICAL HISTORY
e. CHRONIC CONDITIONS

6. ALLERGIES

7. PHYSICAL EXAMINATION
• Lower abdominal tenderness
• Normal or increased bowel sounds
• Dehydration (occasional

8. SPECIFIC DATA LIKE GRADING

9. TESTS TO BE ORDERED
•Stool examination
•CBP
•Serum electrolytes
•Stool culture
•Sigmoidoscopy
•Colonic biopsy

10. ASSESSMENT/PLAN
•Avoid narcotic-related antidiarrheals
•Avoid antimotility agents
•Give oral rehydration solutions
•Give parental nutrition

11. EDUCATION
•Clear liquids followed by a low residue, lactose-free diet are
recommended until symptoms of shigellosis resolve.
•Use of safe drinking water
•Chlorination of unreliable water sources
•Strict hand washing
•Refrigeration and proper preparation and cooking of food
•Food handlers must be treated with antibiotics and should not be
involved in food preparation as long as stool cultures are positive for
Shigella infection.
•Careful hand washing and stool precautions should prevent the
dissemination of shigellosis.

12. MEDICATION
•Ceftriaxone
•Ciprofloxacin
•Trimethoprim-sulfamethoxazole
•Azithromycin

13. FOLLOW UP