Clinical and Paraclinical Findings in Shigelosis

Objective: Shigella infections are one of the major causes of diarrhea worldwide and especially in developing countries. This study was conducted to investigate clinical symptoms, predisposing factors and effective antibiotic regimens in children hospitalized for clinical dysentery.Material & Methods: Children older than 6 months admitted for gastroentritis in Bahrami hospital in Tehran from September 1998 to September 2001 with a positive fecal culture for Shigella were included in this study. The data was gathered from patients' records.Findings: From 173 patients, 46.2% were females mostly aged 2-5 years. More than 50% of patients were admitted in summer. The frequency of anemia was 31.8% and 34.7% were under the median growth curve. Except diarrhea, the most frequent clinical manifestations of shigellosis were fever (98.2%), dehydration (87.2%) and convulsion (68.2%). 135 (78%) patients received Nalidixic acid and the rest was treated with ceftriaxone as the first choice because of their poor condition on admission. Nine (5.2%) patients died with Ekiri syndrome and sepsis manifestation despite antimicrobial treatment. Conclusion: The mortality rate in this study was higher than in other studies. Fifty-six percent of mortality cases was due to Ekiri syndrome and the remainder was due to sepsis in children less than 1 year old. We found no specific clinical symptom or sign for shiglosis.