170.4 📌 章末速蚘

  • Shigella 4 species (S. sonnei high-income, S. flexneri low-income, S. dysenteriae 1 Shiga toxin HUS, S. boydii rare)
  • Low ID 10-100 — explosive outbreak; daycare, MSM, fecal-oral
  • Dysentery (血 + mucus + tenesmus + 高 cramping + 燒)
  • Complications: HUS, toxic megacolon, reactive arthritis HLA-B27, Ekiri 兒童
  • Treatment always: azithromycin or ceftriaxone (vs Salmonella healthy adult 䞍必)
  • MSM cluster — multi-R, azithro preferred but rising R
  • NO loperamide in dysentery (toxic megacolon)
  • Vaccines in development; not routine