An adult case with shigellosis-associated encephalopathy

Area of Science:

• Infectious Diseases
• Neurology
• Public Health

Background:

• Shigella infections are increasing in Western countries, particularly through sexual transmission among men who have sex with men.
• Shigella-induced encephalopathy is a known complication, especially in children (Ekiri syndrome), but is rarely observed in adults.

Observation:

• A 45-year-old man presented with altered neurological status, fever, and diarrhea.
• Initial investigations for bacterial meningitis or viral encephalitis were negative, with only a slight increase in cerebrospinal fluid leucocytes.
• Stool culture identified Shigella flexneri as the causative agent.

Findings:

• The patient was diagnosed with Shigella-associated encephalopathy.
• Rapid recovery was observed following antibiotic treatment.
• This represents the second reported case of encephalopathy in an adult associated with Shigella flexneri enteric infection.

Implications:

• This case underscores the importance of considering Shigella-associated encephalopathy in adults presenting with neurological symptoms and enteric infection, especially within the men who have sex with men community.
• Increased awareness and diagnostic vigilance for this rare complication are crucial for timely and effective treatment.
• The rising incidence of Shigella infections necessitates ongoing public health surveillance and targeted prevention strategies.