The leukemoid reaction in shigellosis.

Area of Science:

• Infectious Diseases
• Hematology
• Pediatrics

Background:

• Shigellosis is a significant cause of diarrheal disease globally.
• Leukemoid reactions, an elevated white blood cell count, can occur during severe infections.
• Understanding factors associated with severe outcomes in shigellosis is crucial for public health.

Purpose of the Study:

• To investigate the association between leukemoid reactions and clinical outcomes in shigellosis patients.
• To identify specific Shigella serotypes linked to leukemoid reactions.
• To determine the impact of leukemoid reactions on the case fatality rate of shigellosis.

Main Methods:

• Retrospective analysis of hospitalized shigellosis patients in Bangladesh.
• Comparison of demographic and microbiological data between patients with and without leukemoid reactions.
• Statistical analysis to determine significant associations.

Main Results:

• Leukemoid reactions occurred in 3.8% of shigellosis patients, predominantly in children under 4 years.
• Leukemoid reactions were significantly associated with younger age (<10 years) and Shigella dysenteriae 1 infection.
• Patients with leukemoid reactions had a higher case fatality rate (21%) compared to those without (7.4%).

Conclusions:

• Leukemoid reactions in shigellosis are strongly associated with young children and Shigella dysenteriae 1.
• The presence of a leukemoid reaction indicates a more severe shigellosis infection with a higher risk of mortality.
• This finding underscores the need for close monitoring and aggressive management of shigellosis in vulnerable pediatric populations.