Diagnostic Code 7322 · 38 CFR §4.114
Bacillary dysentery, more often called shigellosis today, is an intestinal infection caused by Shigella bacteria transmitted through contaminated water, food, or person-to-person contact. The acute illness produces severe bloody diarrhea, abdominal cramping, fever, and rapid dehydration; in severe cases it can cause toxic megacolon, intestinal perforation, or post-infectious complications. Veterans deployed to regions where the bacterium is endemic — large parts of Asia, Africa, and Central America — carry an elevated risk, and shigellosis outbreaks have occurred in military training and operational settings throughout the 20th and 21st centuries. While most acute cases resolve with antibiotic treatment, a subset of veterans develop chronic post-infectious sequelae: irritable bowel syndrome, reactive arthritis (formerly Reiter syndrome), and persistent intestinal scarring. DC 7322 rates the chronic residuals.
| Rating | Criteria |
|---|---|
| 0% | History of bacillary dysentery with no current symptoms — the infection cleared with treatment and stool cultures are negative. |
| 10% | Mild chronic residuals — occasional loose stools, intermittent abdominal cramping, mild dyspepsia, or other low-grade gastrointestinal symptoms. |
| 30% | Moderate chronic residuals — recurring episodes of diarrhea, persistent abdominal pain, weight loss, or evidence of post-infectious complications such as reactive arthritis or chronic intestinal scarring producing functional limitation. |
Stool cultures, PCR, or antigen testing confirming Shigella during an active episode is the standard diagnostic evidence. For historical infections, service medical records documenting the original illness and treatment with antibiotics establish the in-service event. Colonoscopy or imaging showing chronic intestinal scarring documents the residuals. A symptom log over several months captures the recurrence pattern. Records of any reactive arthritis workup (joint symptoms developing after the GI infection, HLA-B27 testing) support secondary claims. Deployment records to a high-prevalence region close the nexus when service medical records are sparse.
No. Shigellosis (DC 7322) is caused by Shigella bacteria; amebiasis (DC 7321) is caused by the protozoan parasite Entamoeba histolytica. Both produce bloody diarrhea, both can be picked up from contaminated water, and both have rating codes for chronic residuals — but they are different infections with different diagnostic tests, different antibiotic regimens, and separate rating codes. Stool studies during the active phase distinguish them.
Yes, when the post-service symptoms fit the chronic-residual or post-infectious pattern. The nexus runs through deployment records to an endemic region plus the current diagnostic picture (chronic IBS, reactive arthritis, intestinal scarring). A gastroenterology or infectious disease nexus opinion connecting the in-service exposure to the current condition closes the case.
Reactive arthritis often develops weeks to months after the original GI infection, but the joint symptoms can persist for years or become chronic. The reactive arthritis is rated separately from the dysentery under the appropriate musculoskeletal code (knee, ankle, sacroiliac joints are the most commonly affected). A rheumatology workup including HLA-B27 testing supports the diagnosis and the nexus opinion linking it to the prior Shigella infection.