Shigellosis is a diarrheal disease with an invasive bacterial pathophysiology resulting in loss of serum and blood into the feces, which probably contributes to the substantial mortality and growth stunting demonstrated to occur with the illness. Loss of serum into the feces was measured in adults with shigellosis using clearance of α 1 -antitrypsin, a serum protein that is not normally excreted in the feces and is resistant to proteolysis. The median loss of serum was 277 ml per day and ranged to greater than one liter. Loss of serum proteins, immune factors and micronutrients during shigellosis is likely to play an important role in malnutrition, risk of subsequent infectious diseases, and mortality.
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Black et al. (1991) studied this question.
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