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November 1987

Shigella Bacteremia in Adults: A Report of Five Cases and Review of the Literature

Author Affiliations

From the Department of Medicine (Drs Morduchowicz, Huminer, and Pitlik); the Infectious Diseases Unit (Dr Drucker); and the Microbiology Laboratory (Dr Block), Beilinson Medical Center, Petah Tiqva; and the Infectious Diseases Unit, Tel Aviv Medical Center and the Sackler School of Medicine, Tel Aviv University (Dr Siegman-Igra), Israel.

Arch Intern Med. 1987;147(11):2034-2037. doi:10.1001/archinte.1987.00370110162025

• Shigella bacteremia is rare, occurring mainly in children. We describe five adult patients with Shigella bacteremia and review data on 22 cases reported in the English-language medical literature. Eighteen (67%) of 27 patients had either an underlying condition or were aged older than 65 years. Most patients had clinical signs of acute febrile gastroenteritis. However, in six patients, the organism was not isolated from stool. Species isolated from blood included Shigella flexneri in 11 patients, Shigella sonnei in eight, and Shigella boydii and Shigella dysenteriae in one patient each. Isolation of the bacterium from blood only was associated with a high mortality rate, in contrast to its isolation both from blood and stool. It is suggested that blood cultures should be obtained from elderly or immunocompromised patients with acute febrile gastroenteritis to detect shigellemia as well as bacteremia caused by other enteric pathogens, such as Salmonella or Campylobacter.

(Arch Intern Med 1987;147:2034-2037)

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