Keywords
How to Cite
Abstract
Shigella mostly causes gastroenteritis and rarely causes sepsis. Mostly malnourished children and elderly immunocompromised population at high risk of blood stream infection. Here, we are presenting a case of a male, aged 73 years. He was a known case of diabetes, hypertension, and ischemic heart disease (history of angioplasty twice) who came into the emergency department on 16th October 2024. The presenting with of loose bloody stools for 5 days, with shortness of breath. Initially, the patient was managed on the line of viral haemorrhagic fever with secondary bacterial infection of the Gastrointestinal tract, including Shigella. The patient was improving with symptomatic treatment and on antibiotics. This case highlights the rarity of and generates awareness among health care workers and physicians to direct their approach considering patient risk factors and clinical deteriorating conditions and early diagnosis of secondary bacterial infections in viral and immunocompromised patients. This approach reduces the hospital stay and cost, risk of treatment failure and mortality rate.
References
Rotramel HE, Zamir HS. Shigella Bacteremia in an Immunocompetent Patient. Cureus. 2021 Nov 20;13(11): e19778. https://doi.org/10.7759/cureus.19778.
Schnupf P, & Sansonetti PJ. Shigella pathogenesis: new insights through advanced methodologies. Microbiol Spectr. 2019, Mar;7(2):BAI-0023, https://doi.org/10.1128/microbiolspec.BAI-0023-2019
Baker S, Scott TA. Antimicrobial-resistant Shigella: where do we go next? Nat Rev Microbiol, 2023; 21:409–410. https://doi.org/10.1038/s41579-023-00906-1
Aslam A, Hashmi MF, Okafor CN. Shigellosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
Raso MM, Arato V, Gasperini G, Micoli F. Toward a Shigella Vaccine: Opportunities and Challenges to Fight an Antimicrobial-Resistant Pathogen. Inter J Mol Sci, 2023; 24(5):4649. https://doi.org/10.3390/ijms24054649
Nayyar C, Thakur P, Tak V, Singh A. Shigella sonnei Sepsis in an Infant: A Case Report. J Clin Diagn Res, 2017; May;11(5):DD01-DD02. doi: 10.7860/JCDR/2017/25594.9796.
Stefanovic A, Matic N, Ritchie G, Lowe CF, Leung V, Hull M, et al. Multidrug-Resistant Shigella sonnei Bacteremia among Persons Experiencing Homelessness, Vancouver, British Columbia, Canada. Emerg Infect Dis, 2023; Aug;29(8):1668-1671. doi: 10.3201/eid2908.230323.
Gupta R, Gupta V, Bhat D, et al. Shigella flexneri Sepsis in a Well-nourished Immunocompetent Child: A Rare Case Report. J Gastrointest Infect, 2021;11:44–46. https://doi.org/10.5005/jp-journals-10068-3046
Nisa I, Qasim M, Driessen A, et al. Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan. Eur J Clin Microbiol Infect Dis, 2020; 39:971–985. https://doi.org/10.1007/s10096-020-03811-0
Khan U, Azeem S. The rising toll of dengue cases in Pakistan every year: An incipient crisis. Ann Med Surg (Lond), 2022: Mar 31;76:103549. doi:10.1016/j.amsu.2022.
CLSI. Performance Standards for Susceptibility Testing. 34th ed. CLSI supplement M100. Clinical and Laboratory Standards Institute Wayne (PA), USA; 2024.
Leber AL, Burnham CA, editors. Clinical microbiology procedures handbook, multi-volume. John Wiley & Sons; 2024.
Mark SHK, Begum M, Das S, Kabir J, Dewan S, Kafee MA. Dengue and Malaria Coinfection in a Young Adult with Atypical Feature. Bangladesh J Medicine 2024; 35: 38-41
Tobin-D’Angelo M, Oosmanally N, Wilson SN, Anderson EJ, Segler S, Poventud L. Shigella Bacteremia, Georgia, USA, 2002–2012. Emerg Infect Dis, 2020;26(1):122-124. https://doi.org/10.3201/eid2601.181698
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2025 Anum Mahmood, Fakhur Uddin, Faisal Iqbal Afridi