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Lethal encephalopathy complicating childhood shigellosis
F B Plötz1, H G Arets, A Fleer
1Department of Paediatric Intensive Care, University Children's Hospital Wilhelmina, Utrecht, The Netherlands.
Insights
Shigella infection can cause lethal toxic encephalopathy in children, leading to brain swelling. Early recognition of headache in shigellosis is crucial for prompt intervention and improved outcomes.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
Background:
- Shigellosis is a common childhood infection.
- Toxic encephalopathy is a rare but severe complication.
Observation:
- A 6-year-old girl experienced rapid neurological decline and cerebral edema.
- Shigella was identified in stool samples despite minimal intestinal or metabolic issues.
Findings:
- Shigella infection can precipitate lethal toxic encephalopathy.
- The underlying pathophysiology remains undetermined.
Implications:
- Headache may signal impending toxic encephalopathy in shigellosis cases.
- Prompt medical intervention is vital to manage cerebral edema and improve survival rates.
Unlabelled:
A 6-year-old girl is described who died following rapid neurological deterioration, ending in lethal cerebral oedema. Despite the absence of severe intestinal and metabolic derangement, Shigella was cultured from the stool. Toxic encephalopathy is responsible for death following this rare complication of childhood shigellosis in developed countries. The pathophysiology is unknown.
Conclusion:
Lethal toxic encephalopathy can be caused by Shigella despite the absence of severe intestinal and metabolic derangement. If shigelllosis is suspected, headache may be a first significant sign for the development of toxic encephalopathy. Early recognition and rapid measures to prevent brain oedema may improve outcome.