Salmonellosis, Shigellosis. General management of diarrhoea

1. Big picture

Acute diarrhoea is common, but the exam expects you to separate simple self-limited watery diarrhoea from dangerous inflammatory/invasive diarrhoea.

The key clinical logic is:

Diarrhoea
   ↓
Assess dehydration and sepsis first
   ↓
Watery or bloody?
   ↓
Any red flags? fever, blood, severe pain, shock, immunosuppression, elderly, outbreak
   ↓
Rehydrate immediately
   ↓
Test stool only when indicated
   ↓
Avoid unnecessary antibiotics
   ↓
Treat specifically if severe, invasive, high-risk, or public health relevant

Salmonella and Shigella are bacterial causes of acute gastroenteritis. Salmonella is classically foodborne and often self-limited. Shigella is highly contagious, spreads fecal-orally, and classically causes dysentery: fever + abdominal cramps + bloody/mucoid diarrhoea + tenesmus.

---