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Shigella dysenteriae type 1 enterocolitis.

G R Caldwell, E A Reiss-Levy, D J de Carle

    Australian and New Zealand Journal of Medicine
    |June 1, 1986
    PubMed
    Summary
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    Shigella dysenteriae type 1 infection caused severe enterocolitis in a traveler, mimicking ulcerative colitis. Complications included bacteremia, DIC, and kidney failure, necessitating colectomy and dialysis.

    Area of Science:

    • Infectious Diseases
    • Gastroenterology
    • Critical Care Medicine

    Background:

    • Shigella dysenteriae type 1 exhibits higher virulence than endemic Australian strains (Shigella flexneri, Shigella sonnei).
    • Travel-associated infections pose diagnostic challenges, particularly when clinical presentation mimics non-infectious conditions.

    Observation:

    • A 22-year-old woman contracted Shigella dysenteriae type 1 during travel to India.
    • She presented with severe enterocolitis, leading to a subtotal colectomy, and her illness was initially difficult to diagnose as infectious due to negative stool cultures.

    Findings:

    • The patient developed severe enterocolitis resembling fulminant ulcerative colitis.
    • Complications included Shigella bacteremia, disseminated intravascular coagulation (DIC), and renal cortical necrosis requiring hemodialysis.

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    Implications:

    • Highlights the potential for severe, systemic complications from Shigella dysenteriae type 1, even in immunocompetent individuals.
    • Underscores the importance of considering infectious etiologies in severe gastrointestinal illness, especially in returning travelers.
    • Emphasizes the need for advanced supportive care, including surgery and dialysis, for managing severe Shigella infections.