Clinical features of bacterial dysentery caused by shigella flexneri and associated with severe neurologic disease

Aim. To assess clinical and epidemiological features of bacterial dysentery caused by Shigella Flexneri 2а in children with severe neurologic comorbidities. Methods. 27 case histories of children with the clinical picture of shigellosis were analyzed. All patients were admitted to the pediatric ward of the hospital of infectious diseases from specialized neuropsychiatric care home in October-November 2013. Results. Clinical picture of bacterial dysentery in examined children was classic. 22 out of 27 children (81.5%, CI 66.9-96.1) had mild disease, 3 (11.1%, CI -0.7-22.9) - moderate, 2 (7.4%, CI -2.5-17.3) - severe form of the disease. In majority of cases, intestinal involvement was manifesting as enterocolitis - in 20 out of 27 patients (74.1%, CI 57.6-90.6). In 3 patients (11.1%, CI -0.7-22.9), shigellosis was manifesting as gastroenterocolitis. In 4 cases (14.8%, CI 1.4-28.2) clinical signs of hemorrhagic colitis were observed. Severe dehydration (2nd and 3rd degree) was registered in 4 out of 27 patients, (14.8%, CI 1.4-28.2), moderate - in 2 (7.4%, CI -2.5-17.3). In 4 out of those 6 patients (66.7%, CI 29-104.4) dehydration was isotonic, in 2 (33.3%, CI 0.4-75) - hypotonic. Conclusion. The infectious disease did not influence the clinical course of concomitant neurologic disorder and did not lead to development of neurologic complications in the admitted patients. In most of the cases shigellosis was mild, and patient’s condition was mostly determined by a concomitant disease.

shigellosis, children, neurologic complications, severe comorbidities