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Published on: February 9, 2024
Recurrent Shigella flexneri Gastroenteritis With Concurrent Rotavirus and SARS-CoV-2 Detection in a Preterm Infant: A
Filippos Filippatos1, Konstantinos Kakleas2
1Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, GRC.
Insights
A six-month-old infant with Shigella flexneri dysentery improved with antibiotics. Recurrent infections highlight the need for careful interpretation of multiplex testing and infection control in pediatric enteric disease.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Gastroenterology
Background:
- Enteric infections in infants can present with severe symptoms.
- Multiplex gastrointestinal panels can detect multiple pathogens simultaneously.
- Differentiating true pathogens from commensals or vaccine strains is crucial.
Abstract:
We report a six-month-old male infant born late preterm at 35 weeks' gestation who presented with fever, moderate dehydration, and bloody mucoid diarrhea. Stool culture yielded Shigella flexneri, while gastrointestinal multiplex testing also detected rotavirus and SARS-CoV-2. Only S. flexneri was culture-confirmed and clinically concordant with dysentery; rotavirus vaccine-strain shedding and incidental SARS-CoV-2 detection could not be excluded. The child improved with rehydration, intravenous cefotaxime, followed by oral azithromycin, and supportive care. Two later episodes at 15 and 18 months again yielded S. flexneri with the same antibiogram and responded to azithromycin. Because rotavirus strain typing, exact vaccination interval, and Shigella molecular typing were unavailable, neither viral causality nor relapse versus reinfection could be confirmed. The case emphasizes cautious interpretation of multiplex results, culture-guided therapy, household transmission risk, and infection-control measures in recurrent pediatric enteric infection.
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