Shigellosis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Yazan Daaboul; Serge Korjian

Patients with shigellosis usually appear lethargic. Physical examination of patients with shigellosis is usually remarkable for diffuse abdominal tenderness in more than 70% of cases and fever in approximately 25% to 40% of cases. Less commonly, physical examination is remarkable for signs of dehydration, such as hypotension, tachycardia, and dry mucous membranes.

• Lethargic
• Toxic-appearing

Vital signs are generally within normal limit, but patients with severe disease and dehydration may have the following vital signs derangements:

• Fever
• Tachycardia
• Tachypnea
• Hypotension

• Poor skin turgor

• Conjunctival pallor
• Xerophthalmia (dry eyes)
• Xerostomia (dry oral mucous membranes)

• Distended bowels
• Hyperactive bowel sounds
• Diffuse abdominal tenderness on light palpation. Abdominal tenderness may be more prominent in lower abdominal quadrants due to involvement of the distal sigmoid colon and/or rectum.

• Flat jugular vein
• Prolonged capillary refill time

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