Cases reported "dysentery, bacillary"

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1/92. Lethal encephalopathy complicating childhood shigellosis.

    A 6-year-old girl is described who died following rapid neurological deterioration, ending in lethal cerebral oedema. Despite the absence of severe intestinal and metabolic derangement, Shigella was cultured from the stool. Toxic encephalopathy is responsible for death following this rare complication of childhood shigellosis in developed countries. The pathophysiology is unknown. CONCLUSION: Lethal toxic encephalopathy can be caused by Shigella despite the absence of severe intestinal and metabolic derangement. If shigelllosis is suspected, headache may be a first significant sign for the development of toxic encephalopathy. Early recognition and rapid measures to prevent brain oedema may improve outcome. ( info)

2/92. family outbreak of dysentery caused by a rhamnose non-fermenting, ONPG-negative strain of shigella sonnei phage type 6.

    Three members of a Scottish family, with no history of foreign travel but who had recently visited Bristol, were infected by a strain of shigella sonnei of phage type 6 (PT 6) that did not ferment rhamnose and was negative for o-nitrophenyl-beta-D-galactopyranoside (ONPG). The incident exposed limitations associated with commercial systems for the identification of strains of S. sonnei with atypical biochemical properties. ( info)

3/92. Sonographic findings in Shigella colitis.

    We present a case of colitis caused by shigella sonnei in which abdominal sonography helped in the early diagnosis, leading to successful conservative management. Sonography showed diffuse wall thickening and layer stratification in the descending and sigmoid colon. Although Shigella colitis is relatively rare, the possibility must be considered when patients have diffuse wall thickening with distinct layer stratification in the left colon. ( info)

4/92. Abrupt increase of tacrolimus blood levels during an episode of Shigella infection in a child after liver transplantation.

    The authors report the case of an 8-year-old girl who underwent a liver transplant at the age of 18 months because of biliary atresia. She was treated with cyclosporin for more than 5 years. Increased hirsutism prompted a change to tacrolimus therapy. During 11 months the mean tacrolimus level was 8.2 ng/mL. The patient was hospitalized because of an episode of Shigella infection and a threefold increase in tacrolimus level was measured. Despite a reduction of tacrolimus dose, the trough tacrolimus levels were in the range of 16.5 to 22.0 ng/mL during the subsequent 2 weeks. On resolution of the diarrhea, tacrolimus levels returned to those observed before the Shigella infection. It is suggested that the marked increase in tacrolimus levels observed in this patient is a direct result of the damage produced to the gastrointestinal mucosa by the Shigella infection. ( info)

5/92. shigella sonnei: another cause of sexually acquired reactive arthritis.

    We report a case of reactive arthritis attributable to sexually-acquired shigella sonnei infection. This occurred in the context of an outbreak of S. sonnei among homosexually-active men in Sydney, australia, in 2000. ( info)

6/92. Chronic vulvovaginitis caused by antibiotic-resistant shigella flexneri in a prepubertal child.

    A 7-year 8-month-old girl was diagnosed with a prolonged course of vulvovaginitis caused by shigella flexneri. The child was symptomatic with intermittent vaginal bleeding, dysuria and foul smelling vaginal discharge for a 3-year period. Initial attempts to resolve the infection with successive courses of antibiotic therapy using ampicillin, trimethoprim-sulfamethoxazole, cefixime and amoxicillin/clavulanic acid failed. The child's infection was finally resolved by a 14-day course of ciprofloxacin. ( info)

7/92. death from multi-resistant shigellosis in fiji islands.

    death from Shigellosis is rare in developed countries, however it causes over a million deaths in developing countries worldwide annually. death from shigellosis is rare in fiji. However, the global problem of emerging multidrug resistance raises some issues about the management of Shigellosis in this country. Within fiji, Shigella is a notifiable disease. The fiji Ministry of health recorded 68 cases of Shigella in 1996, 173 cases in 1997 and 334 cases in 1998 (no data available for 1999). There was only one recorded death during this time--in 1998. Resistance to chloramphenicol occurred in 82% of cases. shigella flexneri in fiji remains sensitive to cephalothin and cefaclor. The current antibiotic guidelines in fiji, recommend that antibiotics be used only for cases of moderate and severe dysentery. Shigellosis was suspected soon after presentation however the patient was unable to take oral antibiotics and was treated with intravenous antibiotics (chloramphenicol and ampicillin), which were ineffective due to resistance of the organism. The current antibiotic guidelines for severe dysentery recommend chloramphenicol or nalidixic acid--the later not available in fiji. However the only intravenous drugs that retain their sensitivity to Shigella-ceftriaxone and cephalothin, are expensive ($F 45.00 per vial of ceftriaxone) and these are only available in large regional hospitals. ( info)

8/92. brachyspira (Serpulina) pilosicoli spirochetemia in an immunocompromised patient.

    The case of an elderly immunocompromised man with non-Hodgkin's lymphoma who presented with fever, abdominal pain and bloody diarrhea is described. brachyspira pilosicoli was isolated from culture. The patient was treated with penicillin g i.v. and became afebrile. B. pilosicoli is a recently recognized enteric pathogen of humans and animals. Intestinal spirochetosis should be included in the differential diagnosis of any immunocompromised or critically ill patient with dysentery. ( info)

9/92. Septic shock associated with shigella flexneri dysentery.

    Septic shock is a very unusual presentation of Shigella infection. We describe a 3-y-old child who developed severe septic shock and severe encephalopathy during an episode of dysentery caused by shigella flexneri. ( info)

10/92. Shigellosis complicating preterm premature rupture of membranes resulting in congenital infection and preterm delivery.

    BACKGROUND: The association of chorioamnionitis with preterm birth is well established. Intra-amniotic infection complicates 13-60% of preterm premature rupture of membranes (PROM) with enteric gram-negative pathogens accounting for 20-40% of recoverable organisms. However, the source of enteric pathogens leading to premature birth has been poorly characterized. CASE: A 36-year-old multiparous woman presented at 2567 weeks with preterm PROM. She reported a 5-day history of bloody, mucous diarrhea. A fourth cesarean delivery was performed secondary to the onset of labor. fetal blood, placental membrane, and vaginal pool cultures revealed the presence of shigella sonnei. With appropriate antibiotic therapy, the patient was discharged home on postoperative day 5. Neonatal stool cultures revealed evidence of in utero fetal transmission. CONCLUSION: It is prudent to treat pregnant patients with clinical symptoms suggestive of shigellosis because this pathogen can result in preterm PROM and preterm delivery. Neonatal testing is indicated if maternal disease is suspected before delivery. ( info)
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