title: Lethal toxic encephalopathy due to childhood shigellosis or Ekiri syndrome.
abstract: Lethal toxic encephalopathy due to shigellosis or Ekiri syndrome is a rare complication of shigellosis with a high fatality rate. Data are very limited on factors that can predict this encephalopathy, so we evaluated clinical and laboratory characteristics for these patients. In this study children with extreme toxicity and convulsions followed by rapid neurological deterioration resulting in brain edema and fatal outcome without sepsis and severe dehydration were selected as having lethal toxic encephalopathy. There were 1295 children with shigellosis during the 10 years of the study. Five children (0.4%) had lethal toxic encephalopathy due to shigellosis. Death occurred following rapid neurological detoriation resulting in brain edema despite intensive treatment. Evidence of brain edema may be a prediction factor for death. Early recognition of encephalopathy and measures to prevent brain edema may improve patient outcome.
authors.affiliation: Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Pourakbari
authors.forename: Setareh
authors.initials: S
authors.lastname: Mamishi
authors.forename: Leila
authors.initials: L
authors.lastname: Kohan
authors.forename: Leila
authors.initials: L
authors.lastname: Sedighi
authors.forename: Shima
authors.initials: S
authors.lastname: Mahmoudi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Fattahi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Teymuri
mesh_terms: D000293:Adolescent; D001929:Brain Edema / Q000175:diagnosis / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004405:Dysentery, Bacillary / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D020258:Neurotoxicity Syndromes / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies