Shigella flexneri Bacteremia in an Immunocompetent Woman With Socioeconomic Risk Factors: A Case Report

Shigella species are responsible for millions of cases of shigellosis each year worldwide, particularly in underdeveloped countries. These bacteria invade the colonic epithelium and release enterotoxins, leading to watery or bloody diarrhea, fever, and abdominal pain. Bacteremia is a rare systemic complication of shigellosis, with only a few cases reported among immunocompetent adults. Here, we present an intriguing case of Shigella flexneri bacteremia in an elderly, immunocompetent woman. Uniquely, the patient's stool tested negative for Shiga toxin despite confirmed shigellemia. In addition to its unusual clinical presentation, this case offers important epidemiologic insights. It underscores the need for clinicians to consider patients' socioeconomic backgrounds when forming a broad differential diagnosis and to remain vigilant for diseases that are less commonly encountered in resource-rich settings.