%0 Journal Article
%T Shigella Bacteremia in a Patient with Visceral Leishmaniasis
%A Mengistu Endris
%A Rezika Mohammed
%A Yegnasew Takele
%A Desalegn Woldeyohannes
%A Moges Tiruneh
%A Ermias Diro
%J Case Reports in Critical Care
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/920729
%X Bacteremia due to Shigella is rare. A 26-year-old HIV-negative male presented with a persistent high-grade fever of two months duration to the Leishmaniasis Research and Treatment Center of University of Gondar Hospital. He was anorexic and had lost significant weight (from 76 to 57£¿kg in 4 months, BMI = 17.2£¿kg/m2). He also complained of headache, chills, and rigor. In the last one year, he was experiencing a few episodes of acute bloody diarrhea, the last episode being two months ago. Microscopy from splenic aspiration showed Leishman-Donovan bodies with parasite load of +3. The blood culture showed Shigella species, but the stool was culture negative. The isolate was sensitive to most tested antibiotic discs, sulfamethoxazole, ceftriaxone, gentamicin, tetracycline, and norfloxacilin, except ampicillin. Therefore, requesting blood culture for identifying unexpected type of organisms causing infections in patients with underlying diseases like visceral leishmaniasis should be encouraged. 1. Introduction Bacteremia due to Shigella is rare. Shigella is a gram-negative, nonmotile facultative anaerobe that causes infection typically confined to the gastrointestinal tract [1]. The disease is mediated by enterotoxin and manifests with acute bloody diarrhea and fever often occurring in an outbreak due to contamination of water [2]. There are few reports of Shigella causing meningitis, osteomyelitis, and sepsis mostly in neonates, malnourished children, and immuno compromised hosts [3¨C8]. It is highly likely that such kind of infection be missed and associated with high risk of death. Shigella rarely invades the bloodstream and results in septic shock. Macrophages not only fail to kill Shigella bacteria that they phagocytize, but also are killed by them [1]. Due to overlapping manifestations of sepsis, blood culture is not a routine examination in visceral leishmaniasis (VL) patients. To the best of our knowledge, Shigella bacteremia was not reported in patients with VL in Ethiopia. Here we report a case of Shigella bacteriemia in a patient with VL. 2. Case Description 2.1. Clinical Presentation A 26-year-old male presented with a persistent high-grade fever of two months duration to the Leishmaniasis Research and Treatment Center of University of Gondar Hospital. He was anorexic and had lost significant weight (from 76 to 57£¿kg in 4 months). He also complained of headache, chills, and rigor. In the last one year, he was experiencing some acute episodes of bloody diarrhea, the last episode being two months ago. He was treated with unspecified medications at a
%U http://www.hindawi.com/journals/cricc/2013/920729/