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P106 Systemic shigellosis – paediatriccase report
  1. Gh Jugulete1,2,
  2. Cristina Popescu1,
  3. Endis Osman1,
  4. Sabina Vintila1,
  5. Madalina Panciu1,
  6. Elena Gheorghe1,
  7. Madalina Merisescu1,2
  1. 1National Institute for Infectious Diseases ‘Prof. dr. Matei Bals’Bucharest
  2. 2University of Medicine and Pharmacy Carol Davila Bucharest

Abstract

Introduction Bacterial dysentery represents an acute intestinal infection caused by an array of species of the Shigella genus, clinically characterised by the dysenteric syndrome – fever, abdominal pain, tenesmuses, bloody, mucoid diarrhoea and, which can sometimes complicate with systemic toxic manifestations.

Material and method We present the case of a young child aged 1 year and 4 months admitted in the 9th Paediatric Department at The National Institute of Infectious Diseases „Prof. Dr. Matei Bals’ for fever, bloody, mucoid diarrhoea, vomiting, poor feeding, and one paroxysmal neurological manifestation associated with altered general status. Biological specimens were collected and immediate treatment was initiated – intravenous fluid therapy, antibiotic (Ceftriaxone), anticonvulsant and symptomatic treatment.

Results Workup revealed leukocytosis with neutrophilia, important inflammatory syndrome, associated hepatic cytolysis and acid-base and hydro-electrolytic imbalances and positive stool cultures for Shigella sonnei were obtained after cultivation on specific media. The neurologic evaluation and EEG confirmed neurological involvement secondary to systemic shigellosis. Under treatment, the child’s general status improved, with subsequent normalisation of the stools and after seven days, the patient was cured and discharged in a normal general state, without any neurological sequelae and with negative stool cultures.

Conclusion The presented case is an example of a toxic systemic form of shigellosis, with favourable evolution and complete clinical recovery, without sequelae but who requires subsequent neurological monitoring. Even though rarely encountered, the systemic severe form of paediatric dysentery can sometimes cause severe complications, sequelae and can lead to death in the absence of adequate treatment.

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