A Case Report of Dysentery Caused by an Unusual Shigella Isolate from South India

Lakshmi Shanmugam, Kamali Doss, Soundarya Rajamanickam, Niranjan Biswal, Jharna Mandal
2022 Acta Scientific Gastrointestinal Disorders  
Shigellosis is one of the leading causes of mortality and morbidity among children less than five years (under-5 children). Available literature report Atypical serotypes of Shigella flexneri from various parts of the world. At present, there are 17 serotypes in S. dysenteriae, 6 serotypes and 14 subserotypes in S. flexneri, 20 serotypes in S. boydii and a single serotype of S.sonnei, 2 phases and 5 biotypes (a, b, e, f and g). Here, we report a strain of mannitol non-fermenting S.flexneri
more » ... ype 4 in a one-year-old girl child presented with high-grade fever and loose stools. Clinical Description: A one-year-old girl child with a known history of absence seizures presented with high-grade fever and loose stools for two days, about 8-9 episodes per day, foul-smelling, mucoid in nature, stained with fresh blood, and abdominal pain. The child also had 2-3 episodes of vomiting, non-bilious, non-blood-stained and contained food particles. Stool sample was plated onto MacConkey agar (MAC) and Xylose Lysine Deoxycholate Agar (XLD agar) and incubated aerobically at 37°C for 16-18 hours.Non lactose fermenting and red colonies were seen in MAC and XLD respectively which was identified subsequently as Shigella flexneri by serogrouping, but was a mannitol non fermentor. The isolate was found to harbour multiple virulence genes by PCR. Conclusion: The child was continued on oral cefixime for 10 days but has not improved following which she was started on Inj. Ceftriaxone 100 mg/kg/day for 5 days and the child improved and discharged subsequently.
doi:10.31080/asgis.2022.05.0450 fatcat:msic4oqt3nbbxby2lnru4yqbju