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Author Spotlight: Advancements in Understanding and Combatting Shigella Infections

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Shigella sonnei Bacteremia Presenting with Profound Hepatic Dysfunction.

Oluwaseun Shogbesan¹, Andrew Rettew², Bilal Shaikh³

¹Department of Internal Medicine, Reading Health System, Spruce Street and 6th Avenue, West Reading, PA 19610, USA.

Case Reports in Gastrointestinal Medicine

|March 23, 2017

Summary

Shigella sonnei bacteremia, though rare, can cause severe liver issues in previously healthy adults. Prompt antibiotic treatment led to full recovery, highlighting the importance of considering this infection in patients with gastrointestinal symptoms and liver dysfunction.

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Area of Science:

Infectious Diseases
Hepatology
Gastroenterology

Background:

Shigellosis is a global health concern, with Shigella bacteremia being uncommon, typically affecting vulnerable populations.
This case highlights a rare presentation of Shigella sonnei bacteremia in an immunocompetent adult.

Observation:

A 27-year-old male with a history of Roux-en-Y gastric bypass presented with diarrhea, abdominal cramps, nausea, vomiting, and jaundice.
Physical examination revealed dehydration, icterus, and fever. Laboratory tests showed leukopenia, elevated liver enzymes (AST, ALT), elevated bilirubin, and coagulopathy.

Findings:

Blood and stool cultures confirmed Shigella sonnei bacteremia.
Imaging revealed hepatic steatosis and right-sided colitis.
Extensive workup excluded other causes of hepatitis.

Implications:

This case underscores the potential for Shigella sonnei to cause significant hepatic derangement and coagulopathy in previously healthy individuals.
Early diagnosis and appropriate antibiotic therapy, such as ciprofloxacin, are crucial for successful treatment and recovery.
Highlights the importance of considering atypical infections in patients with gastrointestinal symptoms and liver injury, especially those with risk factors like gastric bypass surgery.