Lethal encephalopathy complicating childhood shigellosis.
A 6-year-old girl is described who died following rapid neurological deterioration, ending in lethal cerebral oedema. Despite the absence of severe intestinal and metabolic derangement, Shigella was cultured from the stool. Toxic encephalopathy is responsible for death following this rare complication of childhood shigellosis in developed countries. The pathophysiology is unknown.


CONCLUSIONS
Lethal toxic encephalopathy can be caused by Shigella despite the absence of severe intestinal and metabolic derangement. If shigelllosis is suspected, headache may be a first significant sign for the development of toxic encephalopathy. Early recognition and rapid measures to prevent brain oedema may improve outcome.
Department of Paediatric Intensive Care, University Children's Hospital Wilhelmina, Utrecht, The Netherlands.
F B
FB
Plötz
H G
HG
Arets
A
A
Fleer
R J
RJ
Gemke
D016470:Bacteremia / Q000175:diagnosis* / Q000628:therapy; D001929:Brain Edema / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D002648:Child; D004405:Dysentery, Bacillary / Q000175:diagnosis* / Q000628:therapy; D004679:Encephalomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans