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Shigellosis — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsShigellosisSCE Infectious Diseases

A 28-year-old woman returns from Peru with a 7-day history of watery diarrhoea, now bloody, with abdominal cramps and tenesmus. Stool culture grows Shigella sonnei. Antimicrobial susceptibility shows resistance to Ampicillin and Co-trimoxazole but sensitivity to Ciprofloxacin and Azithromycin. She has no features of systemic toxicity. What is the most appropriate treatment?

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Correct answer: B — Ciprofloxacin 500 mg BD for 3 days

Shigellosis with bloody diarrhoea warrants antibiotic treatment. Ciprofloxacin remains first-line for susceptible Shigella in adults. However, increasing fluoroquinolone resistance is being seen globally. Azithromycin is an appropriate alternative. Given the confirmed Ciprofloxacin sensitivity, it is the best choice here. Loperamide is relatively contraindicated in dysentery. Metronidazole is not effective against Shigella.

Reference: UKHSA 2022 – Management of Shigella; WHO 2023 – Diarrhoeal disease treatment