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A case of childhood shigellosis with mutism
M Selimoğlu1, R Akdağ, I Kirpinar
1Department of Pediatrics, Atatürk University Faculty of Medicine, Erzurum, Turkey.
Abstract:
Bacillary dysentery, an acute infection caused by various strains of Shigella, is characterized by abdominal pain, tenesmus, and diarrhea with mucus, pus and blood. Neurologic manifestations including meningismus, delirium and convulsions may accompany the infection. We describe a thirteen-year-old girl who presented with headache, convulsion and loss of consciousness at the onset and developed diarrhea with blood and pus after hospitalization. The diagnosis of shigellosis was based on clinical data and isolation of the microorganism in the stool specimen. After improved physical functions, the patient developed mutism that continued for two days in the course of her illness, despite having no history of neurologic or psychological problems. She was diagnosed by a psychiatrist with organic mental syndrome NOS (Not Otherwise Specified) according to DSM-III-R criteria. None of the conditions that may cause mutism could be confirmed. This is the first reported case of mutism accompanying shigellosis.
Insights
This case study reports a rare instance of mutism in a thirteen-year-old girl diagnosed with shigellosis. The patient experienced neurological symptoms and later developed mutism, highlighting a novel association with this bacterial infection.
Area of Science:
- Infectious Diseases
- Neurology
- Psychiatry
Background:
- Bacillary dysentery, caused by Shigella, presents with gastrointestinal symptoms and can involve neurological manifestations.
- Neurological complications like seizures and delirium are known but less common.
Observation:
- A 13-year-old girl experienced headache, convulsions, and loss of consciousness, followed by bloody diarrhea, indicative of shigellosis.
- Following initial recovery, the patient developed two days of mutism, a condition not previously documented in shigellosis cases.
- Psychiatric evaluation diagnosed organic mental syndrome, with no other identifiable cause for the mutism.
Findings:
- This case represents the first documented instance of mutism associated with shigellosis.
- The patient's mutism occurred despite no prior history of neurological or psychological disorders.
Implications:
- This case expands the spectrum of known neurological complications of Shigella infections.
- It underscores the importance of considering atypical presentations in infectious diseases and their neurological sequelae.