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Author Spotlight: Advancements in Understanding and Combatting Shigella Infections
Published on: February 9, 2024
Multidrug resistant Shigella flexneri : a rare case of septicemia in an infant
Sanjay Jain1, Mukesh Sharma2, Raju Gupta3
1CMO & HOD Department of Microbiology, Hindu Rao Hospital , New Delhi, India .
Insights
Shigellosis can cause rare, fatal extraintestinal complications like septicemia, especially in malnourished children. This case highlights multidrug-resistant Shigella flexneri leading to severe septic shock and death in an infant.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Shigellosis remains a significant public health concern, particularly in developing nations.
- It can lead to severe, uncommon extraintestinal complications, including septicemia, central nervous system (CNS) involvement, urinary tract, and liver issues.
- Prevention is challenging due to the low infectious dose and the rise of multidrug-resistant strains.
Observation:
- A 6-month-old infant presented with gastrointestinal infection and subsequent septicemia.
- The infant developed severe septic shock, disseminated intravascular coagulation (DIC), and convulsions.
- Blood and stool cultures confirmed infection with multidrug-resistant Shigella flexneri.
Findings:
- The case involved a rare presentation of Shigella septicemia with life-threatening complications.
- Multidrug-resistant Shigella flexneri was identified as the causative agent.
- The infant unfortunately expired despite emergency medical management.
Implications:
- This case underscores the potential for shigellosis to manifest as severe, fatal septicemia in infants.
- Clinicians should consider Shigella infection in cases of infant septicemia, particularly when accompanied by diarrhea and vomiting.
- The rise of multidrug-resistant strains necessitates vigilance and appropriate diagnostic approaches in managing pediatric infections.
Abstract:
Shigellosis is still an important public health problem in developing and under-developed countries. It may lead to rare but potentially fatal various extra intestinal complications like septicemia, involvement of CNS, urinary tract and liver especially in young malnourished children. The disease is difficult to prevent as only few bacteria are required for causing infection and there is increasing infection with multi drug resistant strains. A 6-month-old infant developed septicemia caused by multi drug resistant Shigella flexneri during an episode of gastrointestinal infection. The patient was managed in the emergency ward but unfortunately the infant expired. Considering septic shock, blood culture, stool culture and other relevant investigations were done. Stool as well as blood culture yielded Shigella flexneri. The isolates were multidrug resistant. Following is a rare case presentation of Shigella septicemia with severe shock, DIC and convulsions. The case report demonstrates how shigellosis can lead to a rare life threatening complication and hence should be considered as a possibility in septicemia associated with diarrhea and vomiting in infant and young children.
