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Shigella flexneri bacteremia in a child.
Cornelius S Bello1, Ahmed A Al-Barki, Mohamed E El-Awad
1Department of Laboratory, PO Box 34, Abha, Kingdom of Saudi Arabia. cssbello@hotmail.com
Saudi Medical Journal
|May 20, 2003
Summary
A rare Shigella flexneri septicemia case in a child led to severe toxic megacolon and acute abdomen due to necrotizing enterocolitis. This highlights the aggressive potential of Shigella infections in vulnerable populations.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Critical Care Medicine
Background:
- Shigella flexneri is a significant cause of bacterial dysentery worldwide.
- Septicemia and severe gastrointestinal complications are rare but serious manifestations of Shigella infection.
- Necrotizing enterocolitis (NEC) is a critical condition primarily affecting neonates, but can occur in other pediatric populations.
Observation:
- An 8-year-old Saudi child with disabilities residing in a social home presented with symptoms of acute abdomen.
- Clinical examination revealed signs of severe toxic megacolon.
- The child was diagnosed with fulminant necrotizing enterocolitis.
Findings:
- The underlying cause of the severe gastrointestinal distress was identified as Shigella flexneri septicemia.
- The infection led to a rapidly progressing and lethal course of necrotizing enterocolitis.
- The case demonstrated an unusual and severe presentation of Shigella infection in a pediatric patient.
Implications:
- This case underscores the importance of considering Shigella septicemia in the differential diagnosis of acute abdomen and toxic megacolon in children, even in the absence of typical diarrheal symptoms.
- Early recognition and aggressive management are crucial for improving outcomes in severe Shigella infections.
- Further research into risk factors and optimal treatment strategies for severe Shigella-associated gastrointestinal complications in immunocompromised or vulnerable pediatric populations is warranted.